If the results of the screening for COVID-19 were negative, the emergency patient was treated in accordance with the shared protocols (Fig. 2). For example, a 60-year-old man with a recently implanted left ventricular assist device (LVAD) (Jarvik 2000, Jarvik Heart Inc., New York, NY, USA) for end stage heart failure presented at our hospital with dyspnoea, hum from the device and increase of energy consumption by the LVAD. After the COVID-19 screening result was negative, the patient was immediately hospitalized through the green path for treatment of a high suspicion of device thrombosis (despite anticoagulant and antithrombotic therapy and a correct international normalized ratio range). The diagnosis was confirmed by a transoesophageal echocardiogram, which showed a severe smoke-like effect in the left ventricle with serious flow reduction. The patient had an LVAD replacement through an anterior thoracotomy, using cardiopulmonary bypass with a beating heart. Afterwards, the patient was transferred to the green area ICU. He is currently in the ICU; he has acute kidney failure, treated by continuous veno-venous haemofiltration, haemorrhagic stroke with left hemi-syndrome and difficultly being weaned from mechanical ventilation, which required a tracheostomy. He is constantly also monitored for COVID-19. The reason for the LVAD thrombosis is still under investigation due to the correct international normalized ratio and antiplatelet therapy observed. At present, concomitant infections are excluded.