This is an editorial published in the International Journal for Quality in Health care by Micaela La Regina, Michela Tanzini, Vittorio Fineschi, Francesco Venneri, Giulio Toccafondi, Peter Lachman, Riccardo Tartaglia and the COVID-19 INSH Working Group. The authors discuss how the COVID-19 pandemic is severely challenging health systems and societies worldwide. Patient safety of COVID-19 patients is an evolving task.