A new type of coronavirus infection (COVID-19), caused by SARS-CoV-2, is transmitted through respiratory droplets or saliva. High viral loads were detected, soon after symptom onset, in the oropharynx of ill patients, as well as in the asymptomatic subjects. The nasal and oral cavities are therefore directly associated with the transmission of SARS-CoV-2 and could represent the first target in infection control measures. Moreover, in most severe cases of infection, patients show massive systemic levels of pro-inflammatory cytokines, which lead to physiological deterioration and death. Well-timed control of the cytokine storm together with the reduction of lung inflammatory cell infiltration could be the key to improve treatment success as well as, the reduction of the mortality rate. Among several factors affecting viral infection and related inflammatory processes, iron homeostasis disorders play a critical role. In fact, it favors one side, viral progression, and on the other exacerbation inflammatory processes. Lactoferrin (Lf), a glycoprotein able to modulate iron and inflammatory homeostasis, could represent a promising tool able to target multi-faced aspects of the viral progression and pathogenesis. Lf possesses antiviral activity against enveloped and naked viruses by hindering viral entry into host cells through its competitive binding to the cell surface receptors and/or to the virus. This capability of Lf strengthens the idea that this glycoprotein is "an important brick in the mucosal wall, effective against viral attacks". Recently, the role of Lf in the entry of SARS pseudovirus into Myc cells has been investigated, and results obtained revealed that Lf was able to block the binding of the spike protein to host cells. Taken together, these results suggest that Lf could play a protective role in host defense against SARS-CoV-2 infection.
