If you’ve been following the ongoing discussions around COVID 19 and its long term effects, you’ve probably come across long COVID a condition that brings a variety of frustrating symptoms that can linger for months, years, long after the virus has left your body. But what if your long COVID symptoms start feeling like something else? What if you’ve developed dry eyes, dry mouth, or joint pain? Could it be a sign of Sjogren’s syndrome, an autoimmune disorder that causes similar symptoms?
Many people like myself have been diagnosed with both.
What Is Sjogren’s Syndrome?
First, let’s review what Sjogren’s syndrome is, for those who might not be familiar with it. Sjogren’s is an autoimmune disorder where the body’s immune system mistakenly attacks the moisture-producing glands, particularly in the eyes and mouth. The result? A dry mouth (often leading to difficulty swallowing and speaking), dry eyes (that feel gritty or sandy), and in some cases, joint pain, fatigue, and organ damage. Sjogrens is much more than just eyes and mouth but in this article will focus on mainly those 2 aspects.
Common symptoms include:
- Dry eyes and mouth (the hallmark symptoms)
- Fatigue (feeling unusually tired, no matter how much sleep you get)
- Joint pain or swelling
- Swollen glands (especially around the jaw or neck)
- Skin rashes or other dermatological issues
- Difficulty swallowing or speaking due to dry mouth
- Autonomic dysfunction and neurological problems
- immunological consequences
COVID-19 and Long COVID: A Quick Recap
COVID-19, the illness caused by the SARS-CoV-2 virus, primarily attacks the respiratory system, but it can also affect multiple other organs and systems in the body, including the vascular system, nervous system, and immune system.
For some people, symptoms don’t just resolve after a couple of weeks but last years. Long COVID (also called post-COVID syndrome) refers to a range of symptoms that persist long after the acute infection has cleared.
Interestingly, many long COVID symptoms overlap with those of autoimmune disorders, like Sjogren’s syndrome. So, could it be that the immune system’s response to COVID-19 could trigger an autoimmune response that resembles Sjogren’s?
COVID-19 and Sjogren’s Syndrome: Are There Similarities?
It turns out there are some important similarities between Long COVID and Sjögren’s syndrome, particularly when it comes to symptoms and immune system behavior.
Dry Mouth and Dry Eyes
Both Long COVID and Sjögren’s syndrome can cause persistent dryness in the mouth and eyes. While these are hallmark symptoms of Sjögren’s, they have also been reported in Long COVID, likely due to immune system dysregulation following infection. Some people with Long COVID develop sicca symptoms—chronic dry eyes and dry mouth—closely resembling those seen in Sjögren’s.
Fatigue
Fatigue is a major symptom in both conditions. People with Long COVID often describe a level of exhaustion unlike anything they’ve experienced before—persistent, unrelenting, and unaffected by rest. Similarly, fatigue in Sjögren’s syndrome is a defining feature, often described as a debilitating tiredness that doesn’t improve with sleep.
Joint Pain and Swelling
Joint pain is another overlapping symptom. Many individuals with Long COVID report symptoms of so-called “COVID arthritis”, which includes joint pain, stiffness, and swelling. These symptoms are strikingly similar to those experienced in Sjögren’s, where inflammation commonly affects the knees, shoulders, or fingers.
Autonomic Dysregulation
Disruption of the autonomic nervous system—known as dysautonomia—has been observed in both Long COVID and Sjögren’s. This can manifest as heart rate irregularities, blood pressure fluctuations, and heat intolerance, among other symptoms.
Autoimmune Components
Although COVID-19 itself is not classified as an autoimmune disease, it can trigger immune system dysregulation in certain individuals. This dysregulation may lead to autoimmune like symptoms, particularly in people with pre-existing autoimmune conditions like Sjögren’s. Some researchers suspect that COVID-19 may initiate or exacerbate autoimmune activity, potentially flaring up conditions such as Sjögren’s syndrome. This immune system “cascade” may help explain the growing overlap observed between the two conditions.
Can COVID-19 Trigger or Initiate Sjogren’s Syndrome?
This is where things get even more intriguing. Could COVID-19 actually trigger Sjogren’s syndrome in someone who has no prior history of the disease? Research on this connection is still in its early stages, but several studies suggest that COVID-19 can, indeed, trigger autoimmune responses and even initiate autoimmune diseases like Sjogren’s. Here’s how it might work:
- Immune System Overreaction:
In some people, after the acute phase of COVID-19, the immune system doesn’t “calm down” as it should. Instead, it goes into overdrive, attacking the body’s own tissues. This is similar to the mechanism behind autoimmune diseases like Sjogren’s, where the immune system mistakenly targets healthy cells. For some people with long COVID, this immune dysregulation could trigger Sjogren’s symptoms, particularly dry eyes and mouth. - Viral Triggering of Autoimmune Diseases:
Many autoimmune diseases have been linked to viral infections, which can sometimes “trigger” the onset of these diseases. This is true for conditions like rheumatoid arthritis, lupus, and multiple sclerosis. The same may be true for Sjogren’s syndrome. Some studies have shown that viral infections, including Epstein-Barr virus (EBV), can play a role in triggering Sjogren’s. Given that COVID-19 is a viral infection, it’s possible that the SARS-CoV-2 virus could act as a similar trigger for Sjogren’s, especially in individuals who are genetically predisposed to autoimmune diseases. - Persistent Immune System Dysfunction:
A study published in the Annals of the Rheumatic Diseases found that COVID-19 could lead to the activation of autoreactive B cells, which are part of the immune system involved in antibody production. In autoimmune diseases like Sjogren’s, these autoreactive B cells mistakenly target the body’s tissues. So, COVID-19 could potentially spark a long-lasting immune dysfunction, which could manifest as Sjogren’s symptoms in some people.
What Should You Do If You Suspect You Have Sjogren’s After COVID?
If you’ve had COVID-19 or long COVID and have developed symptoms like dry mouth, dry eyes, or joint pain, it’s important to consult your healthcare provider. While these symptoms might be temporary due to COVID-19, they could also be a sign of an emerging autoimmune condition like Sjogren’s.
Your doctor will likely:
- Evaluate your symptoms: Are they related to the ongoing effects of COVID, or could they be part of a developing autoimmune disease?
- Run blood tests: Your doctor may order tests for specific antibodies like anti-SSA or anti-SSB, which are commonly present in Sjogren’s syndrome. They may also check for other markers of autoimmune activity.
- Assess the need for treatment: If Sjogren’s syndrome is diagnosed, your doctor may recommend treatments like artificial tears, saliva substitutes, and immune-modulating medications to help manage the condition.
Conclusion: Can COVID Trigger Sjogren’s Syndrome?
While more research is needed, there does appear to be a link between long COVID and the onset of new autoimmune disease like Sjogren’s syndrome. Both share similar symptoms, and it’s possible that COVID-19 could trigger or exacerbate autoimmune responses, including Sjogren’s. If you’re experiencing dry eyes, dry mouth, or joint pain after recovering from COVID, it’s worth discussing with your healthcare provider. Early diagnosis and treatment can make a big difference in managing symptoms and improving quality of life.
Disclaimer: This article is not medical advice, but rather a general discussion based on current medical literature. Always consult your healthcare provider for diagnosis and treatment options tailored to your specific situation.
Long Covid Journey 