Dear Dr. Roach: I don’t know what to think; perhaps you can help. As an 83-year-old previously healthy, very active woman, I was recently diagnosed first with bronchitis and then with COVID, all in one month. Ten weeks later, I am struggling with dry mouth, gums and lips that no doctor can explain.
Is this one of the long COVID symptoms? I’ve tested negative for the A and B versions of Sjogren’s disease. Can a virus cause an autoimmune disease in a previously healthy person? And is this just something that I have to learn to live with, as it is quite challenging?
C.R.
Sjogren’s disease is an autoimmune disease involving many secretory glands, especially those in the mouth and eye. Dry eye and mouth are cardinal symptoms of the disease, but fatigue, muscle aches and sometimes mild cognitive impairment (“brain fog”) are other common symptoms. Although the anti-Ro and anti-La autoantibodies are usually found with Sjogren’s disease, they are not necessary to make the diagnosis and can be found in healthy people without Sjogren’s disease.
There is a clear connection between Sjogren’s and COVID infections, particularly with severe COVID. Several authors have reported cases where the person who developed symptoms was found to have antibodies and proven to have Sjogren’s disease by biopsy during their hospitalization for COVID. A study in lab animals also showed that a COVID infection can induce the Sjogren’s autoantibodies and reduce saliva and eye secretions.
There is not yet long-term data on the prognosis of Sjogren’s disease following COVID. It is possible that the dry mouth will get better over the months, like with other persistent COVID symptoms. However, it is more likely that COVID triggered Sjogren’s disease, and it may be permanent.
Rheumatologists tend to be the experts for Sjogren’s disease, and there are many treatments available beyond symptomatic treatment of dry eyes and mouth.
Dear Dr. Roach: My wife, 72, had very severe pollen allergies during spring season for the last 37 years. No antihistamine medicine worked for her all these years. Then, this year, after taking all five Moderna COVID-19 vaccines, she didn’t have even a little sign of allergies this year.
Have you heard about this wonderful experience from other people as well?
J.M.
No, I have not heard that from my patients, nor could I find evidence of that in published reports. It doesn’t seem likely to me that a vaccine would reduce sensitivity to pollen, so I wonder if your wife might’ve been less exposed than in previous years.
If she is very careful and uses a N95 mask, that might explain it, but since masks are not usually necessary when being outdoors, I don’t really have a good reason as to why she has had relief from her allergies.
Some people just have spontaneous relief, although most of my patients tend to get worse over time. Of course, there may be relatively good years and bad years.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
