Faust JS, Chen AJ, Nguemeni MJ, et al. - Mortality data from Texas, a racially and ethnically diverse state, are analyzed in order to understand the excess mortality among adults aged 25 to 44 years during the early months of the COVID-19 pandemic.

• Among Black, Hispanic, and White residents of Texas aged 25 to 44 years, COVID-19 was the second leading cause of death during March through December 2020, the first 10 months of the COVID-19 pandemic in the US.

• During the third quarter of 2020, COVID-19 became the most common cause of death with a markedly disproportionate rise in mortality among Hispanic residents.

• This is possibly due to the more frequent employment of Hispanic persons as essential workers and, therefore, their less ability to avoid exposure to SARS-CoV-2, which has previously been linked to socioeconomic factors.

• Another possible explanation is that Hispanic residents less frequently have access to primary care and, therefore, more frequently experience unmanaged medical comorbidities linked with worse COVID-19 outcomes.