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Effect of Lactoferrin on Clinical Outcomes of Hospitalized Patients with COVID-19: The LAC Randomized Clinical Trial

Publicated to:Nutrients. 15 (5): 1285- - 2023-03-01 15(5), DOI: 10.3390/nu15051285

Authors: Matino, Erica; Tavella, Elena; Rizzi, Manuela; Avanzi, Gian Carlo; Azzolina, Danila; Battaglia, Antonio; Becco, Paolo; Bellan, Mattia; Bertinieri, Giovanni; Bertoletti, Massimo; Casciaro, Giuseppe Francesco; Castello, Luigi Mario; Colageo, Umberto; Colangelo, Donato; Comolli, Davide; Costanzo, Martina; Croce, Alessandro; D'Onghia, Davide; Della Corte, Francesco; De Mitri, Luigi; Dodaro, Valentina; Gravina, Alessia; Grillenzoni, Luca; Gusmaroli, Graziano; Landi, Raffaella; Lingua, Anna; Manzoni, Roberto; Marinoni, Vito; Masturzo, Bianca; Minisini, Rosalba; Ortone, Elena; Patti, Giuseppe; Pedrinelli, Anita; Pirisi, Mario; Rizzi, Eleonora; Sola, Daniele; Sola, Mariolina; Tonello, Nadir; Tonello, Stelvio; Topazzo, Gigliola; Tua, Aldo; Vaschetto, Rosanna; Vassia, Veronica; Zecca, Erika; Manzoni, Paolo; Sainaghi, Pier Paolo

Affiliations

AOU Maggiore Carita, Dept Anesthesia & Intens Care Med, I-28100 Novara, Italy - Author
AOU Maggiore Carita, Med Dept, Div Cardiol, I-28100 Novara, Italy - Author
Azienda Ospedaliera SS Antonio & Biagio & Cesare A, Div Internal Med, I-15121 Alessandria, Italy - Author
Azienda Ospedaliero Univ AOU Maggiore Carita, COVID 19 Unit, I-28100 Novara, Italy - Author
Azienda Ospedaliero Univ AOU Maggiore Carita, Dept Internal Med, I-28100 Novara, Italy - Author
Azienda Ospedaliero Univ AOU Maggiore Carita, Div Emergency Med, I-28100 Novara, Italy - Author
Azienda Ospedaliero Universitaria AOU Maggiore Car, COVID 19 Subintens Unit, I-28100 Novara, Italy - Author
Osped Infermi, Dept Maternal Infant Med, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Dermatol, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Diabetol & Endocrinol, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Emergency Med, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Geriatr Care, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Infect Dis, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Internal Med, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Neurol, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Obstet & Gynecol, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Oncol, I-13875 Ponderano, Italy - Author
Osped Infermi, Div Pneumol, I-13875 Ponderano, Italy - Author
Osped Infermi, Intens Care Unit, I-13875 Ponderano, Italy - Author
Univ Piemonte Orientale UPO, Ctr Autoimmune & Allerg Dis, CAAD, I-28100 Novara, Italy - Author
Univ Piemonte Orientale UPO, Dept Hlth Sci, I-28100 Novara, Italy - Author
Univ Piemonte Orientale UPO, Dept Translat Med, I-28100 Novara, Italy - Author
Univ Turin, Dept Med Sci, Azienda Ospedaliero Univ AOU Citta Salute & Sci, Internal Med,Sch Med, I-10126 Turin, Italy - Author
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Abstract

As lactoferrin is a nutritional supplement with proven antiviral and immunomodulatory abilities, it may be used to improve the clinical course of COVID-19. The clinical efficacy and safety of bovine lactoferrin were evaluated in the LAC randomized double-blind placebo-controlled trial. A total of 218 hospitalized adult patients with moderate-to-severe COVID-19 were randomized to receive 800 mg/die oral bovine lactoferrin (n = 113) or placebo (n = 105), both given in combination with standard COVID-19 therapy. No differences in lactoferrin vs. placebo were observed in the primary outcomes: the proportion of death or intensive care unit admission (risk ratio of 1.06 (95% CI 0.63-1.79)) or proportion of discharge or National Early Warning Score 2 (NEWS2)

Keywords

Bovine lactoferrinCovid-19Double-blindDouble-blind clinical triaEfficacHeparan-sulfateInfectionInternalizationLactoferrinLate-onset sepsisMulticenterPlacebo-controlledPreventionRandomizedReceptorsSupplementation

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Nutrients due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position 18/114, thus managing to position itself as a Q1 (Primer Cuartil), in the category Nutrition & Dietetics.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 14.63, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-02, the following number of citations:

  • WoS: 14

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-02:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 51.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 51 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 2.25.
  • The number of mentions on the social network X (formerly Twitter): 4 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Italy.