1. INTRODUCTION
Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in a serious public health threat due to the rapid progression, hospitalization, and death of those infected1. As of August 30, 2023, about 6.9 million people have died worldwide because of COVID-19, with a total of 770 million confirmed cases2. In response, the U.S. Food and Drug Administration (FDA) issued the Pfizer-BioNTech vaccine (BNT162b2 mRNA), followed by two vaccines, Moderna (mRNA-1273) and Janssen/Johnson (traditional viral vector), for licensure and emergent use3.
Immunization against SARS-CoV-2 is one of the most important preventive measures to contain the disease because it prevents the spread of the virus and limits the serious consequences of the infection; therefore, for the development of vaccines, three main factors must be considered: efficacy, immunogenicity, and safety, as well as continuous surveillance and research4. Currently, the authorization of the emerging use of vaccines against SARS-CoV-2 has been approved, including mainly messenger RNA (mRNA) technology vaccines, viral vectors, recombinant protein, inactivated, live attenuated, and DNA vaccines5. To date, 13,499,865,692 vaccines have been administered worldwide2.
In general, vaccines have proven to be safe, although rare but potentially serious adverse effects may occur after vaccination6. Thus, several studies describe a series of neurological (Guillain-Barré)7, cardiovascular (myocarditis)8,9, hematological (hemolytic anemia)10, ophthalmological (optic neuritis)11, endocrinological (Graves’ disease)12 and other complications, with a possible association with the T-cell immune response that vaccines induce.
Case report and case series studies report the occurrence of acute abdomen such as acute appendicitis13, acute pancreatitis14, diverticulitis15, cholecystitis16, and colitis17 as a possible complication of COVID-19 vaccination. These studies are of current interest in surgical and clinical medical practice; therefore, our objective was to perform a systematic review of case reports and case series to describe in detail the possible association, the clinical and demographic characteristics of development of acute abdomen following COVID-19 vaccination.