A SARS-Cov2 infection high-uptake surveillance program on healthcare workers and cancer patients in an Italian Cancer Institute

Background: From the beginning of the 2020, SARS-CoV-2 quickly spread worldwide becoming the main problem for the healthcare systems. Healthcare workers (HCWs) are at higher risk of infection and can be a dangerous vehicle for the spread of the virus. Furthermore, cancer patients (CPs) are a vulnerable population with an increased risk of developing severe and lethal forms of COVID-19. Therefore, at the National Cancer Institute of Naples, a surveillance program aimed to prevent the hospital access of SARS-CoV-2 positive subjects (HCWs and CPs) was implemented. The study aims to describe the results of the monitoring activity for the SARS-CoV-2 spread among HCWs and CPs, from March 2020 to March 2021. Methods: This surveillance program included a periodic sampling through nasopharyngeal molecular swab for SARS-CoV-2 (real time-PCR). CPs were submitted to the molecular test at least 48 hours before hospital admission. Multiple logistic regression models were performed among HCWs and CPs to assess the main SARS-CoV-2 risk factors. Results: Overall 1510 HCWs and 12401 CPs were tested with PCR for the detection of SARS-CoV-2 in different time points. SARS-CoV-2 was detected in 20 (1.7%) HCWs of the 1204 subjects during 1st wave, and 127 (9.2%) of 1385 in the 2nd wave (p<0.001); among CPs, the prevalence varied from 3.8% during 1st and 3.4% during the 2nd wave (p=0.5). Multivariate logistic analysis provided a significant OR for nurse (OR = 2.24, 95% CI 1.23-4.08 p<0.001) compared to Research, Administrative staff and other job titles. Conclusions: Our findings underline that the adoption of stringent measures has been essential to contain the shock wave of SARS-CoV-2 infection in the hospital setting. In a far-sighted way, these measures involved both staff and patients. Among HCWs, nurses are more exposed to contagion.