ROME (AP) 鈥� Pope Francis鈥� respiratory infection is presenting a 鈥渃omplex clinical picture鈥� that will require further hospitalization, the Vatican said Monday, as concerns grew about the increasingly frail health of the 88-year-old pontiff.
Vatican spokesman Matteo Bruni said the results of tests conducted in recent days and Monday indicate the pope is suffering from a polymicrobial respiratory tract infection that has necessitated a second change in his drug therapy since being hospitalized Friday. Scientists say polymicrobial diseases are caused by a mix of viruses, bacteria, fungi and parasites.
There was no timeframe given for his hospitalization, which at Day 4 has already sidelined Francis for longer than Bruni said the complexity of his symptoms 鈥渨ill require an appropriate hospital stay.鈥�
In a late update Monday, Bruni said Francis' condition was 鈥渟tationary,鈥� and that he had resumed some work activities and reading.
Francis had part of one lung removed after a pulmonary infection as a young man and is prone to bouts of bronchitis in winter. He was admitted to Rome鈥檚 Gemelli hospital in a 鈥渇air鈥� condition on Friday after a weeklong bout of bronchitis worsened. Doctors confirmed a respiratory tract infection and prescribed 鈥渁bsolute rest鈥� alongside unspecified drug therapies. Subsequent updates said his slight fever had gone away and .
Bruni said ate breakfast, read the newspapers and received the Eucharist on Monday after a third peaceful night. And in a sign Francis was still keeping up with some of the essentials of his routine, the parish priest of the Catholic Church in Gaza, the Rev. Gabriel Romanelli, reported that Francis had maintained his daily video call to the church on Friday and Saturday night. He sent a text message on Sunday.
鈥淲e heard his voice. It's true, it was more tired,鈥� Romanelli told Vatican News. 鈥淏ut we heard his voice clearly and he listened to us,鈥� said the Argentine priest, whom Francis has phoned every day of the Gaza war.
What is bronchitis?
Bronchitis, or an inflammation of the airwaves, can be relatively mild in a healthy person but can become much more severe in someone who is older or has existing lung problems, especially when they are unable to cough up and expel the accumulating mucus. Bacteria and other organisms can colonize, leading to further infection that may be harder to treat.
Dr. Maor Sauler, who specializes in adult pulmonary medicine and critical care at Yale School of Medicine, said it's not uncommon for people suffering from bronchitis to develop an infection with more than one organism in their lungs. The concern, however, is that antibiotics and other drug therapies don't work in isolation and require the body to respond, which given Francis' other problems may make recovery more challenging.
"Being older, wheelchair-bound, all those are risk factors for a situation in which we can鈥檛 treat it despite our best efforts,鈥� said Sauler, who is not involved in Francis' care.
As people get older, their immune systems don鈥檛 work as well, making doctors especially concerned when elderly patients develop multiple problems. A decline in lung function and muscle strength can also impair the body's ability to effectively clear respiratory secretions, increasing susceptibility to infections like pneumonia, a deeper and far more serious infection of the lungs鈥� air sacs.
鈥淚t鈥檚 in the public record that he鈥檚 had chest problems in the past, he鈥檚 been admitted to hospital with pneumonia (in 2023), he's had part of one lung removed," noted Dr. Nick Hopkinson, medical director of the Asthma + Lung UK foundation, who is not involved in Francis' treatment. 鈥淎ll of that makes him a little bit more vulnerable potentially, but we just have to wait and see.鈥�
He said that after doctors have identified clinically what is wrong, they can start treating the underlying infection with the correct therapies.
Pope's frail health
The Argentine pope is a known workaholic who keeps up a grueling pace despite his .
In addition to his frequent bouts of respiratory infections in winter, he uses a wheelchair, walker or cane because of bad knees and suffers from sciatica nerve pain. In 2021 he had 33 centimeters (13 inches) of his colon removed because of a narrowing, and then had a further surgery in and repair an abdominal hernia.
When he had a bad case of pneumonia in 2023, he left the hospital after three days and only acknowledged after the fact that he had been admitted urgently after feeling faint and having a sharp pain in his chest. This time around, Francis insisted on finishing his morning audiences Friday before leaving the Vatican, even though he was having trouble speaking at length because he was so short of breath.
Some appearances have been scrapped
Francis鈥� continued hospitalization has already forced the cancellation of some events connected to the Vatican鈥檚 Holy Year and put others in question. The official Vatican calendar online has no more papal appointments or activities for February, and picks up only on March 5, Ash Wednesday. This week鈥檚 weekly general audience was canceled.
Outside the Gemelli hospital, people were praying for the pope, including Nigerian nuns in front of a giant statue of St. John Paul II. He had so many hospitalizations at Gemelli that the main entry way is decorated with a permanent photo exhibition of his ailments over the course of his quarter-century pontificate.
Sister Mary Beatrice Nnenji said prayers were necessary 鈥渂ecause no one is strong enough on their own.鈥�
鈥淲ith age also you feel your health and especially with his workload and all the efforts he makes,鈥� she said. 鈥淪o if God wants he will go on. Let鈥檚 hope in God, we cannot go against it, whatever comes.鈥�
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Cheng, an AP medical writer, contributed from London. Associated Press visual journalist Trisha Thomas in Rome contributed to this report.
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Associated Press religion coverage receives support through the AP鈥檚 with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.
Nicole Winfield And Maria Cheng, The Associated Press
