Start boiling your pasta noodles according to the package. Make sure to reserve 1 cup of pasta water.
Combine the egg yolks, parmigiano reggiano, and pecorino romano in a bowl. Set it to the side.
In a pan over medium heat, add the olive oil and pancetta. Fry until it's crispy and darker in color. This should take 5-10 minutes. Once it's done, remove it from the pan and the pancetta to the side.
Add the Italian sausage to the same pan. Cook the sausage, breaking it up as you go, for about 7-10 minutes.
Add the garlic, salt, and red pepper flakes to the sausage. Cook for an additional 1-2 minutes.
Add the tomato puree and turn the heat to low. Let it simmer for 5 minutes.
Add the pasta noodles to the sauce along with ¾ cup of pasta water. Combine.
Add the remaining ¼ cup of pasta water to the egg mixture stirring constantly so that the eggs don't scramble. This should result in a smooth mixture.
Remove the pan with the pasta from heat.
Stir in the egg mixture, making sure everything is completely combined.
Add the pancetta back into the pasta and serve.