Abstract
Background: From the beginning of 2020, Severe Acute Respiratory Syndrome Coronavirus 2 (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 Coronavirus Disease 19 (COVID-19). Therefore, at the National Cancer Institute of Naples, where only cancer patients are treated, 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 swabs for SARS-CoV-2 (Real-Time Polymerase Chain Reaction, RT-PCR). CPs were submitted to the molecular test at least 48 h before hospital admission. Survival analysis and multiple logistic regression models were performed among HCWs and CPs to assess the main SARS-CoV-2 risk factors. Results: The percentages of HCWs tested with RT-PCR for the detection of SARS-CoV-2, according to the first and the second wave, were 79.7% and 91.7%, respectively, while the percentages for the CPs were 24.6% and 39.6%. SARS-CoV-2 was detected in 20 (1.7%) HCWs of the 1204 subjects tested during the first wave, and in 127 (9.2%) of 1385 subjects tested in the second wave (p < 0.001); among CPs, the prevalence of patients tested varied from 100 (4.6%) during the first wave to 168 (4.9%) during the second wave (p = 0.8). The multivariate logistic analysis provided a significant OR for nurses (OR = 2.24, 95% CI 1.23–4.08, p < 0.001) compared to research, administrative staff, and other job titles. Conclusions: Our findings show that the positivity rate between the two waves in the HCWs increased over time but not in the CPs; therefore, the importance of adopting stringent measures to contain the shock wave of SARS-CoV-2 infection in the hospital setting was essential. Among HCWs, nurses are more exposed to contagion and patients who needed continuity in oncological care for diseases other than COVID-19, such as suspected cancer.
Highlights
Was the first European state to be seriously affected by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic [1]
Maximum attention was paid to Healthcare workers (HCWs) since they can represent an important vehicle for the spread of the virus, especially among vulnerable populations, such as cancer patients who are at increased risk of becoming ill with more serious symptoms of SARS-CoV-2 infection [4,5,6,7,8,9]
The Charité algorithm (Berlin, Germany) worked out by Corman et al [13], which is based on Real-Time PCR (RT-PCR) SARS-CoV-2 detection of E and RdRp genes, was used as a reference method
Summary
Was the first European state to be seriously affected by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic [1]. In the second pandemic wave between September and December 2020, the epidemiological surveillance addressed different population groups including students, teachers, school workers, healthcare workers (HCWs), and patients who needed hospital treatment for diseases other than COVID-19, such as suspected cancer. This surveillance was achieved through serological tests and nasopharyngeal swabs. Among these categories, maximum attention was paid to HCWs since they can represent an important vehicle for the spread of the virus, especially among vulnerable populations, such as cancer patients who are at increased risk of becoming ill with more serious symptoms of SARS-CoV-2 infection [4,5,6,7,8,9]. Among HCWs, nurses are more exposed to contagion and patients who needed continuity in oncological care for diseases other than COVID-19, such as suspected cancer
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