The cause of encephalitis lethargica is debatable. At that time, it was thought to be due to the influenza virus like Covid 19 virus. Later modern theories implicated Streptococcus viridans and Entero virus of the Polio family. There was an influenza pandemic in the world corresponding to the evolution of EL suggesting a cause-effect relationship. The somnolence and fatigue syndrome of EL is similar to the fatigue of Covid 19 infection. Therefore, Covid 19 pandemic can also present with encephalitis lethargica and its catastrophic sequalae. This has been described vividly in the Oliver Sachs book - The Awakening. The population of Europe was reduced to half by encephalitis lethargica similar to the widespread mortality of the Covid 19 pandemic.
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