Our data also show that while patients with abnormal stress SPECT-MPI findings during the previous years 2017–2019 were older with higher proportion of diabetes and hypertension compared with those with normal imaging results, during pandemic COVID-19 outbreak, there was no difference between patients with normal and abnormal tests as regards to these clinical risk factors. This finding is not surprising given the high concern for vulnerability to COVID-19 in frail patients such as elderly subjects with hypertension and diabetes [19, 20]. Hence, it is reasonable that regarding frail population, the anxiety to become exposed to COVID-19 contagion while performing medical controls and diagnostic procedures has dominated the will to monitor CAD development on both sides of therapeutic alliance, from patient side through media communication and from health system side who was focused on relocation resources on COVID-19 pandemic management.