Frequency of residual fatigue in the recovery phase of Guillain-Barré syndrome: a systematic review and meta-analysis

Guillain-Barré Syndrome (GBS) is an inflammatory neuropathy that causes long-term sequelae in patients. Fatigue is one of those residual syndromes frequently reported to affect the quality of life. We used the PRISMA methodology to include all the studies that estimated the frequency of fatigue using validated scales. A total of 1176 records were identified with the search strategies, of which we finally included 12 studies with 1498 patients, comprising cohort and cross-sectional studies. All the studies used the Fatigue Severity Scale. The pooled frequency of fatigue in patients with GBS was 32% (95% CI: 22%–44%). The heterogeneity among studies was considerably high (I2 = 93%). We did a subgroup analysis and found that the frequency of fatigue was significantly lower in countries with low-middle income (8% [95% CI: 3–21%]) than in countries with high income (39% [95% CI: 29–51%]). These findings suggest that fatigue is a common chronic symptom in the recovery phase of GBS. However, the differences in the studies may reflect the differences in methodological aspects and patient characteristics. More studies are needed to understand the functional burden of fatigue in GBS, especially in low-income settings.