Besides SARSCoV2 RTPCR screening, serological screening comprising the detection of IgM, IgA, or IgG antibodies to SARSCoV2specific epitopes has the potential to play an important role in the confirmation in individual patients with suspected COVID19 symptoms, or for the past SARSCoV2 infections [1]. Fiftyseven articles, including 11 serologicbased IgG, IgM, and total antibodies assays for SARSCoV2, published before June 2024, were included in this metaanalysis. The main outcome of this metaanalysis used to evaluate the overall performance of 11 assays included pooled diagnostic odds ratio (DOR), area under the summary receiver operating characteristic (AUC), and summary receiver operating characteristic curve (SROC). The R software was used for adjusted indirect comparison to calculate the relative diagnostic odds ratio (RDOR) with corresponding 95% confidence intervals (CIs), and indirect comparison forest plots showed the results. == Results == A total of 57 articles met the eligibility criteria for inclusion in our metaanalysis. The pooled DOR and the AUC for access SARSCoV2 IgG were 564.28 (95% CI 229.581386.91) and 1.00, and as for EDI novel coronavirus COVID19 IgG those were 85.27 (95% CI 53.99134.68) and 0.95, for EDI novel coronavirus COVID19 IgM were 49.42 (95% CI 16.47148.30) and 0.86, for Leuprolide Acetate iFlashSARSCoV2 IgG were 652.31 (95% CI 362.321174.41) and 0.97, for iFlashSARSCoV2 IgM were 36.72 (95% CI 12.42108.54) and 0.76, for MAGLUMI 2019nCoV IgG were 145.44 (95% CI 59.37356.30) and 0.90, for MAGLUMI 2019nCoV IgM were 21.59 (95% CI 14.2732.67) and 0.59, for orthoclinical antiSARSCoV2 IgG were 719.46 (95% CI 262.341973.13) and 1.00, for orthoclinical antiSARSCoV2 total were 1104.60 (95% CI 395.643083.99) and 1.00, for Siemens SARSCoV2 total (COV2T) were 1143.37 (95% CI 316.494130.62) and 0.99, for Wantai SARSCoV2 total Ab were 1014.98 (95% CI 618.481665.66) and 1.00. The pooled DOR for assaysbased IgG (n= 43), assaysbased total antibody (n= 35), and assaysbased IgM (n= 20) was 242.88 (95% CI 157.66374.16), 1215.90 (95% CI 547.142702.07), and 40.99 (95% CI 22.6374.25). The diagnostic accuracy of assaysbased total antibody performed better than those of assaysbased IgG and assaysbased IgM; assaysbased IgG performed better than assaysbased IgM. == Conclusion Leuprolide Acetate == This study suggested that this Siemens SARSCoV2 total (COV2T), orthoclinical antiSARSCoV2 total, and Wantai SARSCoV2 total experienced the best overall diagnostic accuracy. The diagnostic efficacy of the assaysbased total antibody experienced statistically significantly higher accuracy than those of assaysbased IgG and assaysbased IgM for COVID19. Keywords:adjusted indirect comparison, COVID19, metaanalysis, SARSCoV2, serological assays We aimed to compare the diagnostic accuracy of 11 commercial serological assays for coronavirus disease2019 (COVID19) by taking the reverse transcriptase polymerase chain reaction (RTPCR) assays as reference standard, which served as control arm to conduct an indirect comparison of diagnostic accuracy for 11 different SARSCoV2 serological assays. == 1. Introduction == Severe acute respiratory coronavirus 2 (SARSCoV2), a novel coronavirus that caused coronavirus disease 2019 (COVID19), has become a pandemic threat in which serological Leuprolide Acetate screening from diagnosis to epidemiologic surveillance has been indispensable in the past 5 years. The molecular screening with realtime reverse transcription polymerase chain reaction (RTPCR) for the detection of SARSCoV2 was the reference standard for COVID19 diagnosis. Besides SARSCoV2 RTPCR screening, serological testing comprising the detection of IgM, IgA, or IgG antibodies to SARSCoV2specific epitopes has the potential to play an important role in the confirmation in individual patients with suspected COVID19 symptoms, or for the past SARSCoV2 infections [1]. Immune response to SARSCoV2 included cellmediated and antibodymediated immunity [2]. The spike (S) glycoproteins with their receptorbinding domain name (RBD) and the nucleocapsid (N) protein were widely used as the most common antigens in commercial serological assays for the detection of specific antibodies [3,4]. In specific contexts, serological screening might be instrumental Leuprolide Acetate for acute diagnostic purposes, particularly when the RTPCR fails to identify SARSCoV2, for example, in patients who are greater than 14 days from their onset of symptoms [5]. Freund et al. reported that serological markers as part of medical followup of symptomatic COVID19 patients can be used Leuprolide Acetate for prognostication; the study found antiS levels were significantly associated with previous severe COVID19 [6]. In addition, serological screening has been reported to be significant and important for personalized vaccination plans. Vaccines are designed to induce antibodies to the S antigen or RBD [7]; vaccineinduced antibodies may arise in response to the S antigen and are, therefore, potentially detectable by any assay using the S antigen or RBD. Freund et al. GPR44 also reported that this trajectory of antiS IgG levels after vaccination was found to predict the response to future COVID vaccinations, and.