They found that inflammation profiling was able to predict the presence of COVID-19 in critically ill patients with 98 per cent accuracy. There were not enough data to compare the accuracy of different tests.
When carried out in the first week of a patient having symptoms only about 30% of people with Covid-19 were picked up by tests of two main types of antibodies, rising to about 70% of people with Covid-19 between eight to 14 days after the onset of symptoms.
Timing is crucial when it comes to antibody tests, experts have warned, after a review of studies found their accuracy is far lower if used within the first fortnight of coronavirus symptoms than a week or two later.
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807 people would receive a negative test result but 17 (2%) of those people would have COVID-19 (known as false negative result).
Jon Deeks, professor of Biostatistics and head of the Test Evaluation Research Group at the University of Birmingham, said: "We've analysed all available data from around the world and discovered clear patterns telling is that timing is vital in using these tests". If in a population about 5% have had COVID-19 - more likely in national surveys - the researchers believe that four infections would be missed for every thousand people tested, and 12 outcomes would be falsely positive.
The investigators sampled the surfaces and air of six negative pressure non-intensive care unit rooms with 13 laboratory-confirmed COVID-19 patients - two of whom had no symptoms - who had returned from overseas and were in an isolation ward in Chengdu, China. The tests do not work accurately when administered at the wrong time.
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The researchers cautioned against over-reliance on antibody testing, as the studies into their effectiveness have been small-scale and involved selected hospital patient groups.
The studies were often small, did not use the most reliable methods, and results were often incomplete, Cochrane said in its 310-page report.
The phenomenon has become a trending topic on social media and earlier research has suggested the lesions are associated with asymptomatic or mild COVID-19, although findings to date have been inconclusive, the researchers said. "All we know is how many samples were tested". In one important United Kingdom study the biomarker manufacturers did not approve the identification of the tests that had been evaluated.
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Another study, this time led by researchers in Belgium, conducted a similar study into purplish-red chilblain-like lesions on the feet (29 patients) and hands (three patients) of individuals seen at a Brussels dermatology clinic in April. The study is published this week in Critical Care Explorations. "However, the design, execution and reporting of studies of the accuracy of COVID-19 tests requires considerable improvement, and action needs to be taken to ensure that all results of test evaluations are available in the public domain and not withheld by test manufacturers to ensure we can provide the best estimates of the accuracy for these tests".