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PurposeThis paper aims to analyse the roles of relational capital (RC) and knowledge management (KM) during the COVID-19 in Italian public and private hospitals, considering that intangible elements are essential during periods of uncertainty.Design/methodology/approachAuthors used a qualitative design in a case study on two Italian hospitals that have different ownership structures, which are located in the epicentre of the pandemic in Lombardy. The study was carried out using the CAOS ("caratteristiche personali", "ambiente", "organizzazione" and "start-up") model (Paoloni, 2021), which allows for comprehending and commenting on RC because of the connections between typical factors that influence an organisation. The model also allows for discussion of the use of a network and how it supports organisations.FindingsFindings of the analysis showed that during the management of the COVID-19 health emergency, ownership structure was not a discriminating factor, the created relationships were similar and they were considered in the same way. The relationships were mainly formal (except for contributions by associations or individuals) and temporary. The RC's reactive role in overcoming crises was confirmed, and the findings indicated that this result was possible also, thanks to the KM's role played within the organisation.Originality/valueTheoretical implications of the work are that it contributes to the sparse healthcare literature on intellectual capital (IC) and on RC and its relationships with KM. The practical implications are related to the creation of new relationships during the healthcare emergency between hospitals and the central government, which can be considered a useful lesson for the future. The theoretical implications derived from the analysis are generalisable to all organisations regardless of their type and location, as well as the practical implications are applicable to the entire national territory.