P0043 - COVID-19 Vaccine-Induced Acute Pancreatitis: A Systematic Review

Mahrukh Tariq, MBBS¹, Amlish Gondal, MD², Gaurang H.. Suhagiya, MBBS³, Priyank M. Dholakiya, MBBS⁴, Fnu Girish, MBBS⁵, Aman Kumar, MBBS⁵, Diksha Suchwani, MBBS⁵, Kajal Bai, MBBS⁶, Tazeen Nazar, MBBS⁷, Bilal Aziz, MBBS⁷, Zahoor Ahmed, MD^8
1Rawalpindi Medical University, Rawalpindi, Punjab, Pakistan; ²Guthrie Robert Packer Hospital, Sayre, PA; ³Jiangsu University, Zhenjiang, Jiangsu, China; ⁴GMERS Medical College and Hospital, Amreli, Gujarat, India; ⁵Ghulam Muhammad Mahar Medical College, Sukkur, Sindh, Pakistan; ⁶Chandka Medical College, Larkana, Sindh, Pakistan; ⁷King Edward Medical University, Lahore, Punjab, Pakistan; ⁸Rochester General Hospital, Rochester, NY

Introduction: Despite the remarkable efficacy of COVID-19 vaccines in preventing severe illness and death, concerns about potential gastrointestinal (GI) adverse events (AE) have emerged. Recent reports suggest a possible link between COVID-19 vaccine and acute pancreatitis (AP), but large-scale characterization of this patient group is lacking. Our study aims to evaluate and summarize the evidence regarding COVID-19 vaccine-induced AP.

Methods: We conducted a systemic literature search using PubMed, EMBASE, and Google Scholar. Our search strategy included the MeSH term and keywords for "COVID-19 vaccine" and "pancreatitis" from date of inception to May 30, 2024. Initial search yielded 361 articles. After excluding irrelevant studies, duplicates, and review articles, we included 45 articles reporting the COVID-19 vaccine-induced AP. Data were extracted and analyzed on patient demographics, vaccine type, time to onset of symptoms, clinical presentation, and outcomes.

Results: Our study included 46 patients of COVID-19 vaccine-induced AP with a median age of 55 ± 18.13 years (range: 14-84). Of those, 60.86% were female. Of COVID-19 vaccines, 71.74% were mRNA, and Pfizer-BioNTech was the most common vaccine involved (41.30%), followed by Moderna (30.43%) and AstraZeneca (17.39%). Symptoms typically appeared with a median of 6 ± 3.48 days post-vaccine, predominantly after the second dose (45.65%). Common symptoms included vomiting (97.82%), abdominal pain (95.65%), and nausea (89.13%). Elevated serum lipase and amylase levels were observed in all cases. Imaging (CT and ultrasound) confirmed AP in 71.73% of patients. Most cases were mild (60.87%) or moderately severe (30.43%), with peripancreatic fluid collection being the most frequent complication (23.91%). The median hospital stay was 7 ± 5.20 days, and all patients recovered with supportive care, albeit 19.56% required ICU admission (Table 1).

Discussion: Precise etiology of COVID-19 vaccine-induced AP is unknown and is believed to be related to a complex interplay of molecular mimicry, autoimmune response, direct pancreatic injury by vaccine components, or systemic inflammatory response. Albeit rare, AP is a life-threatening complication of the COVID-19 vaccine, warranting urgent evaluation and management. COVID-19 vaccine should be included in the etiology of AP in patients presenting post-vaccination abdominal pain and vomiting, requiring continued surveillance and standardized reporting of vaccine-related GI-AEs.


Disclosures:


Mahrukh Tariq, MBBS¹, Amlish Gondal, MD², Gaurang H.. Suhagiya, MBBS³, Priyank M. Dholakiya, MBBS⁴, Fnu Girish, MBBS⁵, Aman Kumar, MBBS⁵, Diksha Suchwani, MBBS⁵, Kajal Bai, MBBS⁶, Tazeen Nazar, MBBS⁷, Bilal Aziz, MBBS⁷, Zahoor Ahmed, MD⁸. P0043 - COVID-19 Vaccine-Induced Acute Pancreatitis: A Systematic Review, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.