Background COVID-19 has impacted acute stroke care with several reports showing worldwide drops in stroke caseload during the pandemic . We studied the impact of COVID-19 on acute stroke care in our health system serving Southeast Michigan as we rolled out a policy to limit admissions and transfers . Methods in this retrospective study conducted at two stroke centers, we included consecutive patients presenting to the ED for whom a stroke alert was activated during the period extending from 3/20/20 to 5/20/20 and a similar period in 2019 . We compared demographics, time metrics, and discharge outcomes between the two groups . Results of 385 patients presented to the ED during the two time periods , 58% were African American . There was a significant decrease in the number of stroke patients presenting to the ED and admitted to the hospital between the two periods (p <0.001). In 2020, patients had higher presenting NIHSS (median : 2 vs 5, p = 0.012), discharge NIHSS (median : 2 vs 3, p = 0.004), and longer times from LKW to ED arrival (4.8 vs 9.4 h, p = 0.031) and stroke team activation (median : 10 vs 15 min, p = 0.006). In 2020, stroke mimics rates were lower among African Americans . There were fewer hospitalizations (p <0.001), and transfers from outside facilities (p = 0.015). Conclusion a trend toward faster stroke care in the ED was observed during the pandemic along with dramatically reduced numbers of ED visits, hospitalizations and stroke mimics . Delayed ED presentations and higher stroke severity characterized the African American population, highlighting deepening of racial disparities during the pandemic.