Stroke affects over 101 million people worldwide and is ranked the second most fatal disease in the world, with 6.5 million deaths in 20191. Comorbid conditions of stroke are critical contributors to burden of stroke and the duration of the comorbid conditions can further determine the severity of stroke risk or mortality. Prevalence for comorbid conditions range from 43% to 94% and estimates can go as high as 99% above 66 years of age2. Prevalence and mortality risk in stroke has often been evaluated from socio-economic viewpoint, but it is also critical to understand the differences in drivers such as comorbid conditions. It is the accumulated risk of comorbid conditions that enhances the risk of stroke further. Are these comorbid conditions differentially impacted by socio-economic factors and ethnogeographic factors. This was clearly evident in COVID era, when COVID-19 differentially impacted the risk of stroke, possibly due to its differential influence on the comorbidities of stroke.