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Apart from their short-term effects, emerging evidence suggests that poststroke immune changes may also adversely affect long-term cognitive outcomes in patients with stroke, increasing the risk of poststroke neurodegeneration and dementia. Infections at the time of stroke may also increase immune dysregulation after the stroke, further exacerbating the risk of cognitive decline. This review will cover the role of acute infections, including respiratory infections such as COVID-19, as a trigger for stroke; the role of infectious burden, or the cumulative number of infections throughout life, as a contributor to long-term risk of atherosclerotic disease and stroke; immune dysregulation after stroke and its effect on the risk of stroke-associated infection; and the impact of infection at the time of a stroke on the immune reaction to brain injury and subsequent long-term cognitive and functional outcomes. Finally, we will present a model to conceptualize the many relationships among chronic and acute infections and their short- and long-term neurological consequences. This model will suggest several directions for future research.<\/jats:p>","DOI":"10.1161\/strokeaha.120.030429","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T18:00:06Z","timestamp":1599588006000},"page":"3156-3168","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":245,"title":["Infection as a Stroke Risk Factor and Determinant of Outcome After Stroke"],"prefix":"10.1161","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2562-1156","authenticated-orcid":true,"given":"Mitchell S.V.","family":"Elkind","sequence":"first","affiliation":[{"name":"Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY. 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