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. 2021 Apr 13;30(160):200298.
doi: 10.1183/16000617.0298-2020. Print 2021 Jun 30.

The prevalence and related factors of fatigue in patients with COPD: a systematic review

Zjala Ebadi  1   2 , Yvonne M J Goërtz  3   4   5   2 , Maarten Van Herck  3   4   5   6 , Daisy J A Janssen  3   7 , Martijn A Spruit  3   4   5 , Chris Burtin  6 , Melissa S Y Thong  8 , Jean Muris  9 , Jacqueline Otker  10 , Milou Looijmans  1 , Christel Vlasblom  1 , Joëlle Bastiaansen  1 , Judith Prins  1 , Emiel F M Wouters  4   11 , Jan H Vercoulen  1 , Jeannette B Peters  1
Affiliations

The prevalence and related factors of fatigue in patients with COPD: a systematic review

Zjala Ebadi et al. Eur Respir Rev. .

Abstract

Background: Fatigue is a distressing symptom in patients with COPD. Little is known about the factors that contribute to fatigue in COPD. This review summarises existing knowledge on the prevalence of fatigue, factors related to fatigue and the instruments most commonly used to assess fatigue in COPD.

Methods: Pubmed, PsycINFO, EMBASE, Cochrane and CINAHL databases were searched for studies from inception up to 7 January 2020 using the medical subject headings "COPD" and "Fatigue". Studies were reviewed in accordance with PRISMA guidelines.

Results: 196 studies were evaluated. The prevalence of fatigue ranged from 17-95%. Age (r=-0.23 to r=0.27), sex (r=0.11), marital status (r=-0.096), dyspnoea (r=0.13 to r=0.78), forced expiatory volume in 1 s % predicted (r=-0.55 to r=-0.076), number of exacerbations (r=0.27 to r=0.38), number of comorbidities (r=0.10), number of medications (r=0.35), anxiety (r=0.36 to r=0.61), depression (r=0.41 to r=0.66), muscle strength (r=-0.78 to r=-0.45), functional capacity (r=-0.77 to r=-0.14) and quality of life (r=0.48 to r=0.77) showed significant associations with fatigue.

Conclusions: Fatigue is a prevalent symptom in patients with COPD. Multiple physical and psychological factors seem to be associated with fatigue. Future studies are needed to evaluate these underlying factors in integral analyses in samples of patients with COPD.

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Conflict of interest statement

Conflict of interest: Z. Ebadi has nothing to disclose. Conflict of interest: M.J. Goërtz has nothing to disclose. Conflict of interest: M. Van Herck has nothing to disclose. Conflict of interest: D.A.J. Janssen reports personal fees from Novartis, Boehringer Ingelheim and AstraZeneca, outside the submitted work. Conflict of interest: M.A. Spruit reports grants from Netherlands Lung Foundation, Stichting Astma Bestrijding, Boehringer Ingelheim and AstraZeneca, during the conduct of the study; and personal fees from Boehringer Ingelheim and AstraZeneca, outside the submitted work. Conflict of interest: C. Burtin has nothing to disclose. Conflict of interest: M.S.Y. Thong has nothing to disclose. Conflict of interest: J. Muris has nothing to disclose. Conflict of interest: J. Otker has nothing to disclose. Conflict of interest: M. Looijmans has nothing to disclose. Conflict of interest: C. Vlasblom has nothing to disclose. Conflict of interest: J. Bastiaansen has nothing to disclose. Conflict of interest: J. Prins has nothing to disclose. Conflict of interest: E.F.M. Wouters has nothing to disclose. Conflict of interest: J.H. Vercoulen has nothing to disclose. Conflict of interest: J.B. Peters has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
PRISMA flow chart.
FIGURE 2
FIGURE 2
Factors associated with fatigue in COPD. Balloon sizes reflect numbers of studies reported. Increased line width indicates higher mean scores of correlation coefficients (r) found. For each factor, correlation coefficient ranges from different studies are shown. For the categorical variable “sex”: male=0, female=1. Other categorical variables (e.g. SES, marital status) not specified. AECOPD: acute exacerbations of COPD; BMI: body mass index; FEV1: forced expiratory volume in 1 s; HRQoL: health-related quality of life; MED: number of medications; MS: marital status; SES: socioeconomic status.
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