Advanced early diagnostics for infectious diseases through electrochemiluminescence

Rapid, sensitive and accessible diagnosis is central for improving the management of infectious diseases, particularly in vulnerable populations and settings where access to centralized testing is limited. Hence, this review examines recent advances in electrochemiluminescence (ECL) biosensing for early pathogen detection, with a focus on the coordination chemistry of typical luminophores, metal–based nanostructures and hybrid materials that underpin assay performance. Particular attention is devoted to transition-metal complexes, coordination polymers, supramolecular and porous hosts, and metal-organic and inorganic nanoplatforms capable of acting as ECL emitters, as well as on coreactant carriers and recognition scaffolds in immunoassays, aptamer– and oligonucleotide–based sensing, on imaging strategies and portable formats such as paper–based and microfluidic devices. Across representative examples targeting whole viruses and bacteria, pathogenic nucleic acids or clinically relevant biomarkers, these architectures have achieved high analytical sensitivity and, in several cases, are compatible with point-of-care implementation. Overall, the work critically discusses structure–property relationships governing ECL efficiency, signal amplification and assay robustness, and outlines design principles for next-generation ECL platforms aimed at bridging the gap between analytical performance and practical clinical implementation in both high- and low-resource healthcare contexts, supporting earlier diagnosis, improved treatment decisions, and broader infection surveillance.