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The coronavirus disease 2019 (COVID-19) pandemic has created challenges in the delivery of acute stroke care. In this study, we analyze the characteristics, evaluation, treatment, and in-hospital outcomes of patients presenting with acute ischemic stroke (AIS) pre-COVID-19 and during COVID-19. Get With The Guidelines-Stroke is a national registry of adults with stroke in the United States. Using this registry, we identified patients with a diagnosis of AIS before (n=39 113; November 1, 2019-February 3, 202 and after (n=41 971; Februa