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.