Molecular mechanisms for thrombosis risk in black people: a role in excess mortality from COVID-19

We read with great interest your recent article by Fogarty et al,[1] in particular their conclusion that differences in thrombotic risk may contribute to ethnic differences in mortality from Covid-19. This is particularly important in the UK, where age- and sex-adjusted hospital death rates for Covid-19 are 2.17 higher for people with ethnicity recorded as black compared to white people, and 1.95 higher for those recorded as Asian.[3] This excess mortality is persists after adjustment for deprivation, body mass index (BMI), smoking and comorbidities,[3] and despite correction for region, rural/urban living, deprivation, household composition, socioeconomic status and health.[2] As yet uninvestigated factors such as thrombosis may contribute to the UK’s ethnic disparities in Covid-19. Similarly data from the USA shows that in 14 states, African-Americans represent 33% of hospitalisations for Covid-19, despite making up 14% of the catchment population.[4]