Pneumonia; Aspiration; Intestinal infarction; Intestinal ischaemia; Small intestinal obstruction; COVID-19; SARS-CoV-2 test positive; Blood creatinine increased; Blood pH normal; Blood phosphorus increased; Brain natriuretic peptide; C-reactive protein increased; Computerised tomogram abdomen abnormal; Computerised tomogram thorax abnormal; Mental status changes; PCO2 decreased; PO2 decreased; Pneumatosis; Procalcitonin; Red blood cell sedimentation rate increased; Toxicologic test normal; Troponin increased; White blood cell count increased; This spontaneous report received from a health care professional via a Regulatory Authority (Vaccine Adverse Event Reporting System) (VAERS ID: private) on 28-JAN-2022 concerned an 86 year old male of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: coronary atherosclerosis, and other pre-existing medical conditions included: The patient had Coronary atherosclerosis of unspecified type of vessel native or graft encounter for long-term current use of other medications. The patient had occlusion and stenosis of carotid artery without mention of cerebral infarction and unspecified hyperlipidemia and unspecified essential hypertension and had chronic kidney disease and ischemic stroke, and dementia. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 204A21A expiry: unknown) dose was not reported, 1 total, administered on 02-SEP-2021 for an unspecified indication. Concomitant medications included acetylsalicylic acid for drug used for unknown indication, atorvastatin for drug used for unknown indication, donepezil for drug used for unknown indication, doxycycline for drug used for unknown indication, lisinopril for drug used for unknown indication, and piperacillin sodium/tazobactam sodium for drug used for unknown indication.  The patient was admitted on 07-JAN-2022 to emergency room from nursing home with chief complaint of altered mental status. He was only oriented to himself. It was stated that patient was afebrile blood pressure, and had stable saturation 90 percent on room air. On same day he had aspiration pneumonia intestinal infarction intestinal ischaemia small intestinal obstruction, covid-19, sars-cov-2 test positive, blood creatinine increased, blood Ph normal, blood phosphorus increased, brain natriuretic peptide, c-reactive protein increased, computerised tomogram abdomen abnormal, computerised tomogram thorax abnormal, mental status changes, pco2 decreased, po2 decreased, pneumatosis, procalcitonin, red blood cell sedimentation rate increased, toxicologic test normal, troponin increased, white blood cell count increased. Laboratory data included: Blood creatinine (NR: not provided) 2.8 increased, Blood pH (NR: not provided) 7.42 pH normal, Blood phosphorus (NR: not provided) 6.2 increased, Brain natriuretic peptide (NR: not provided) not reported, C-reactive protein (NR: not provided) 320 increased, Computerised tomogram abdomen (NR: not provided) abnormal CT findings suggested that a small bowel obstruction complicated by bowel ischemia and secondary bowel infarction with pneumatosis and small bowel mesenteric venous air, Computerised tomogram thorax (NR: not provided) abnormal, PCO2 (NR: not provided) 33 increased, PO2 (NR: not provided) 60.92 decreased, Procalcitonin (NR: not provided) 25, Red blood cell sedimentation rate (NR: not provided) 57 increased, SARS-CoV-2 test (NR: not provided) positive, Toxicologic test (NR: not provided) normal, Troponin (NR: not provided) 13.10 ng/L, and White blood cell count (NR: not provided) 19 increased, Computerised tomogram chest (NR: not provided) Left lower lobe aspiration and or pneumonia. On same day patient was hospitalized for 5 days. He was on room air and placed on comfort measures. The patient was discharged on 12-JAN-2022. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from aspiration, pneumonia, intestinal infarction, intestinal ischaemia, small intestinal obstruction, covid-19, sars-cov-2 test positive, blood creatinine increased, blood ph normal, blood phosphorus increased, brain natriuretic peptide, c-reactive protein increased, computerised tomogram abdomen abnormal, computerised tomogram thorax abnormal, mental status changes, pco2 decreased, po2 decreased, pneumatosis, procalcitonin, red blood cell sedimentation rate increased, toxicologic test normal, troponin increased, and white blood cell count increased. This report was serious (Hospitalization Caused / Prolonged). This report was associated with product quality complaint: 90000215022. The suspected product quality complaint has been confirmed to be the reported allegation could not be determined a manufacturing related root cause could not be identified based on the PQC evaluation/investigation performed.  Additional information was received from Central Complaint Vigilance Department on 03-FEB-2022. The following information was updated and incorporated into case narrative: Product quality complaint investigation result.; Sender's Comments: V2: The version updates Product quality complaint investigation result. This updated information does not alter the company causality of previously reported events. 20220157779-Covid-19 vaccine ad26.cov2.s-Pneumonia, aspiration, intestinal infarction, intestinal ischaemia, small intestinal obstruction, covid-19, sars-cov-2 test positive, blood creatinine increased, blood ph normal, blood phosphorus increased, brain natriuretic peptide, c-reactive protein increased, computerised tomogram abdomen abnormal, computerised tomogram thorax abnormal, mental status changes, pco2 decreased, po2 decreased, pneumatosis, procalcitonin, red blood cell sedimentation rate increased, toxicologic test normal, troponin increased, and white blood cell count. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).