Of 2512 COVID-19 patients, 35 (1.39%, mean age 63.3 years, 54% women) had AIS. AIS recognition was frequently delayed after COVID-19 symptoms (median 19.5 days). AIS mechanism was undetermined or due to multiple etiologies in most cases (n=20, 57%). Three patients from the second cohort each received one dose of an mRNA COVID-19 vaccine. Comparative analysis showed that patients in the later cohort had earlier AIS presentation, fewer stroke risk factors, more comprehensive workup, more defined stroke mechanisms, lower incidence of critical COVID-19 severity, and greater utilization of IV TPA. Despite these differences, AIS incidence, NIHSS, and overall outcomes were similar, with most patients experiencing worsening or static functional 3-month outcomes.