Background: As COVID-19 infection continues to spread, there are increasing reports about its differential impact on racial/ethnic minorities in the United States. African Americans have worse clinical outcomes including hospitalization and mortality compared to Caucasians or Asians. Role of racial/ethnic differences in inherent thromboinflammatory milieu with COVID-19 infection remains unexplored. Methods: Medline, Cochrane Central Register of Controlled Trials, Embase, EBSCO, Web of Science, and CINAHL databases were searched for articles elaborating on COVID-19 pathophysiology and racial/ethnic differences in thrombotic biomarkers from inception through June 14, 2020. Data were used for qualitative analysis. Findings: A total of 98 articles were included in the qualitative analysis. COVID-19 infection is characterized as an immuno-thrombo-inflammatory syndrome with thrombotic microangiopathy strongly influencing clinical outcomes. Several biomarkers have been associated with severe COVID-19 including markers of thrombosis/coagulation (e.g. D-dimer, prothrombin time, etc.) and inflammation (C-reactive protein, ferritin, etc.). In this review, we summarize the reported genetic differences in the inherent thromboinflammatory milieu among different populations with increased risk of thrombosis in African Americans and increased bleeding risk particularly in Asian populations. We elaborate on the limitations of the traditional coagulation biomarkers and propose thromboelastography and rotational thromboelastometry to determine the dynamic functional clot characteristics. Interpretation: Hemostasis profiling may provide clinically relevant information of thrombotic risk used to understand the racial disparities and could be used in personalizing antithrombotic treatment strategies in COVID-19 infection.Funding Statement: NoneDeclaration of Interests: Dr. Kreutz has received consulting fees from Haemonetics. Dr. Jeong has received honoraria for lectures from AstraZeneca, Sanofi-Aventis, Daiichi Sankyo/Lilly, Haemonetics, Otsuka, Han-mi Pharmaceuticals and Yuhan Pharmaceuticals; and research grants or support from AstraZeneca, Korean Society of Interventional Cardiology, Han-mi Pharmaceuticals, Yuhan Pharmaceuticals, Otsuka and Haemonetics. Dr. Gurbel reports serving as a consultant fees/receiving honoraria from Daiichi Sankyo, Bayer, AstraZeneca, Merck, Boehringer, New Haven Pharmaceuticals, Janssen, and CSL and receiving grants from the National Institutes of Health, Daiichi Sankyo, CSL, AstraZeneca, Harvard Clinical Research Institute, Haemonetics, New Haven Pharmaceuticals, Duke Clinical Research Institute, Sinnowa, and Coramed. Dr Gurbel has patents in the field of platelet function testing. Other authors report no disclosure.