Background: The 2019 novel coronavirus disease MESHD is an outbreak of respiratory illness first detected in Wuhan, China in the end of Dec, 2019. The older patients complicated with underlying diseases MESHD are reported more likely to have clinical symptoms. But its secondary lesion is rarely reported. Case presentation: We reported two cases of coronavirus infected pneumonia MESHD pneumonia HP with acute ischemic stroke HP stroke MESHD in patients at their middle- age TRANS. In both 2019 coronavirus diseases MESHD cases, neurological physical examination are normal before infection MESHD. Lymphocytopenia and high expression of cytokines and D-dimer were found from serum SERO clinical laboratory test at admission. The dysarthria MESHD dysarthria HP and limb muscle weakness HP muscle weakness MESHD are initial manifestations in one week after 2019 novel coronavirus infection MESHD. The head CT and head/neck arterial CTA showed small-vessel occlusion. The patients were diagnosed with coronavirus diseases MESHD with secondary acute ischemic stroke HP stroke MESHD. They were treated with tirofiban and followed up with daily aspirin and atorvastatin. Conclusion: The present cases suggested that secondary ischemic stroke HP stroke MESHD, which mainly manifested as small-vessel occlusion, should be considered for coronavirus disease MESHD patients with prompt diagnosis and treatment.