Objective To develop the efficacy of time resolved fluorescence immunoassay (TRFIA) for the detection of COVID-19 specific IgM antibodies. Methods A total of 36 COVID-19 patients in our hospital (From January 2020 to March 2020) and 36 common fever patients excluding COVID-19 in the same period were selected for TRFIA detection and GICA detection of specific IgM antibodies. The specific IgM antibody levels of COVID-19 patients and common fever patients were compared, and the results of TRFIA and GICA detection of COVID-19 specific IgM antibody were counted, and the diagnostic efficacy (sensitivity, specificity and accuracy) and the results of COVID-19 specific IgM antibody of different disease courses were calculated. Results The specific IgM antibody level of COVID-19 patients was higher than that of patients with normal fever (P<0.05). TRFIA detected 34 true positive and 34 true negative COVID-19 specific IgM antibodies. GICA detected 26 true positive and 33 true negative COVID-19 specific IgM antibodies. The sensitivity and accuracy of TRFIA in detecting COVID-19 specific IgM antibody were 94.44% and 94.44% respectively higher than those of GICA(72.22% and 81.94%) (P<0.05). The specificity of TRFIA and GICA was 94.44% and 91.67%, respectively, the difference was not statistically significant (P>0.05). The positive rate of specific IgM antibody increased first and then decreased with the prolongation of the onset time. Conclusion The specific IgM antibody level of COVID-19 patients is relatively high, and TRFIA detection can improve the diagnostic sensitivity and accuracy, and the positive results first increase and then decrease as the disease progresses, which is conducive to the early diagnosis and monitoring of the treatment process, with high clinical application value.