Perspective

The hygiene hypothesis, the COVID pandemic, and consequences for the human microbiome

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PNAS February 9, 2021 118 (6) e2010217118; https://doi.org/10.1073/pnas.2010217118

  1. Edited by Lora V. Hooper, University of Texas Southwestern Medical Center, Dallas, TX, and approved December 14, 2020 (received for review August 3, 2020)

This article has been updated

Abstract

The COVID-19 pandemic has the potential to affect the human microbiome in infected and uninfected individuals, having a substantial impact on human health over the long term. This pandemic intersects with a decades-long decline in microbial diversity and ancestral microbes due to hygiene, antibiotics, and urban living (the hygiene hypothesis). High-risk groups succumbing to COVID-19 include those with preexisting conditions, such as diabetes and obesity, which are also associated with microbiome abnormalities. Current pandemic control measures and practices will have broad, uneven, and potentially long-term effects for the human microbiome across the planet, given the implementation of physical separation, extensive hygiene, travel barriers, and other measures that influence overall microbial loss and inability for reinoculation. Although much remains uncertain or unknown about the virus and its consequences, implementing pandemic control practices could significantly affect the microbiome. In this Perspective, we explore many facets of COVID-19−induced societal changes and their possible effects on the microbiome, and discuss current and future challenges regarding the interplay between this pandemic and the microbiome. Recent recognition of the microbiome’s influence on human health makes it critical to consider both how the microbiome, shaped by biosocial processes, affects susceptibility to the coronavirus and, conversely, how COVID-19 disease and prevention measures may affect the microbiome. This knowledge may prove key in prevention and treatment, and long-term biological and social outcomes of this pandemic.

Footnotes

  • ↵1To whom correspondence may be addressed. Email: bfinlay{at}msl.ubc.ca or tamara.giles-vernick{at}pasteur.fr.

  • Author contributions: B.B.F., K.R.A., M.A., M.J.B., T.C.G.B., H.C., M.G.D.-B., S.D.E., E.E., N.G.-Z., P.G., K.G., F.K., T.K., M.J.M.-N., M.K.M., M.N., S.P., H.P., T.R., C.T., L.Z., and T.G.-V. wrote the paper.

  • The authors declare no competing interest.

  • This article is a PNAS Direct Submission.

Data Availability.

All study data are included in the article.

Change History

March 8, 2021: Reference 77 has been updated; please see accompanying Correction for details.

Published under the PNAS license.

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The hygiene hypothesis, the COVID pandemic, and consequences for the human microbiome
B. Brett Finlay, Katherine R. Amato, Meghan Azad, Martin J. Blaser, Thomas C. G. Bosch, Hiutung Chu, Maria Gloria Dominguez-Bello, Stanislav Dusko Ehrlich, Eran Elinav, Naama Geva-Zatorsky, Philippe Gros, Karen Guillemin, Frédéric Keck, Tal Korem, Margaret J. McFall-Ngai, Melissa K. Melby, Mark Nichter, Sven Pettersson, Hendrik Poinar, Tobias Rees, Carolina Tropini, Liping Zhao, Tamara Giles-Vernick
Proceedings of the National Academy of Sciences Feb 2021, 118 (6) e2010217118; DOI: 10.1073/pnas.2010217118
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Proceedings of the National Academy of Sciences: 118 (6)
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