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Proposed abstract & title for pathogenesis manuscript #746

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1 change: 1 addition & 0 deletions build/assets/custom-dictionary.txt
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decr
defensin
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deltacoronaviruses
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21 changes: 19 additions & 2 deletions content/07.pathogenesis.md
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## Pathogenesis and Transmission
## Genomic and Viral Structure of SARS-CoV-2 in the Context of Pathogenesis, Symptomology, and Transmission
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Title is great!


### Abstract

The novel coronavirus SARS-CoV-2, which emerged in late 2019, has been a major force shaping the year 2020 as it spread around the world infecting tens of millions of people with coronavirus disease 2019 (COVID-19).
While the viral species was unknown prior to January 2020, its similarity to other coronaviruses that infect humans has allowed for rapid insight into the mechanisms that it uses to infect human hosts, as well as the ways in which the human immune system can respond.
Here, we contextualize SARS-CoV-2 among other coronaviruses and identify what is known and what can be inferred about its behavior once inside a human host.
Because the genomic content of coronaviruses, which specifies the virus's structure, is highly conserved, early genomic analysis provided a significant head start in predicting viral pathogenesis.
The pathogenesis of the virus offers insights into symptomology, transmission, and individual susceptibility.
Additionally, prior research into interactions between the human immune system and coronaviruses identifies how these viruses can evade the immune system's protective mechanisms.
We also explore systems-level research into the regulatory and proteomic effects of SARS-CoV-2 infection and the immune response.
Understanding the structure and behavior of the virus serves to contextualize the many facets of the COVID-19 pandemic and can influence efforts to control the virus and treat the disease.

### Importance

COVID-19 involves a number of organ systems and can present with a wide range of symptoms.
Understanding how the virus infects epithelial cells, however, serves to contextualize how these systems connect.
Similarly, the modes of viral transmission have been under debate throughout much of 2020, yet the available research suggests that these patterns are very similar to those seen with the closely related viruses SARS-CoV-1 and possibly MERS-CoV.
Exploring the structure, phylogeny, and pathogenesis of the virus therefore helps to guide interpretation of the broader impacts of the virus on the human body and on human populations.
For this reason, an in-depth exploration of viral mechanisms is critical to a robust understanding of the COVID-19 pandemic.

### Introduction

The current coronavirus disease 2019 (COVID-19) pandemic, caused by the _Severe acute respiratory syndrome-related coronavirus 2_ (SARS-CoV-2) virus, represents an acute global health crisis.
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#### Pediatric Presentation

The presentation of COVID-19 infection can vary greatly among pediatric patients and, in some cases, manifests in distinct ways from COVID-19 in adults.
Evidence suggests that while children and adolescents tend to have mostly asymptomatic infections, those that are symptomatic exhibit a mild illnesss [@doi:10.1101/2020.06.25.20140178; @doi:10.1056/NEJMc2005073; @doi:10.1111/apa.15270; @doi:10.1126/science.abe5765].
Evidence suggests that while children and adolescents tend to have mostly asymptomatic infections, those that are symptomatic exhibit a mild illness [@doi:10.1101/2020.06.25.20140178; @doi:10.1056/NEJMc2005073; @doi:10.1111/apa.15270; @doi:10.1126/science.abe5765].
A review examined symptoms reported in 17 studies of children infected with COVID-19 during the early months of the COVID-19 epidemic in China and one study from Singapore [@doi:10.1001/jamapediatrics.2020.1467].
Of the more than a thousand cases described, the most common reports were for mild symptoms such as fever, dry cough, fatigue, nasal congestion and/or runny nose, while three children were reported to be asymptomatic.
Severe lower respiratory infection was described in only one of the pediatric cases reviewed.
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