Il Nuovo Postiglione - Pope breathing without mask after respiratory attacks: Vatican

The 88-year-old Argentine pontiff, head of the Catholic Church since 2013, "slept all night long and continues to rest" following Monday's crisis, the Holy See said.

As of Tuesday morning, Francis had switched from an oxygen mask to high-flow oxygen delivered through a cannula, a plastic tube which tucks into the nostrils, a statement read.

He is continuing his treatment and respiratory physiotherapy, it added.

In its evening update on Monday, the Vatican stressed Francis's prognosis remained "reserved" -- an indication that doctors cannot predict the likely outcome of his condition.

Francis, who leads the world's 1.4 billion Catholics, was admitted to Rome's Gemelli hospital on February 14 with bronchitis, which developed into pneumonia in both lungs.

His admission has sparked widespread alarm, and well-wishers across the world have been praying for his recovery.

The pope, who had part of a lung removed as a young man, had already suffered two breathing crises in the days running up to Monday's double attack.

The pope had "experienced two episodes of acute respiratory failure, caused by a significant accumulation of endobronchial mucus and consequent bronchospasm", the Vatican said on Monday evening.

Acute respiratory failure, which can be life-threatening, occurs when the lungs cannot pass enough oxygen into the blood or when carbon dioxide builds up in the body.

- 'Very bad sign' -

Francis had been breathless and struggled to read his texts in the days leading up to his admission to the Gemelli hospital, which has a special papal suite on the 10th floor.

On February 22, he suffered a "prolonged asthmatic respiratory crisis", followed on February 28 by "an isolated crisis of bronchospasm" -- a tightening of the muscles that line the airways in the lungs.

Medical experts warned Francis's continued stay in hospital and the repeated crises were alarming.

"At 88 years old, being in the hospital for two weeks and having repeated episodes of respiratory discomfort is a very bad sign," Bruno Crestani, head of the pulmonology department at Bichat hospital in Paris, told AFP.

Herve Pegliasco, head of pulmonology at the European Hospital in Marseille, added that with double pneumonia, "there is the issue of exhaustion, because he is forced to make much more effort to breathe".

The Vatican said on Monday the pope was alert and cooperative during his latest crisis, which required two separate bronchoscopies, where doctors look into the air passages using a small camera at the base of a flexible tube.

- No visits planned -

Francis has been working during his time in the Gemelli, talking on the telephone and receiving some officials, according to Vatican sources.

No visits were planned on Tuesday, the Vatican press office said.

Francis has not been seen in public for almost three weeks and the last photos taken of him were from his private audiences on the morning of his admission to hospital.

The Argentine missed his traditional Angelus prayer for a third straight Sunday and the Vatican issued a written text instead.

In it, the pope thanked the well-wishers around the world who have been holding prayers for his recovery, including outside the hospital and every evening at St. Peter's Square in the Vatican.

"I feel all your affection and closeness and, at this particular time, I feel as if I am 'carried' and supported by all God's people. Thank you all," he said.

Francis has suffered numerous health issues in recent years, including colon surgery in 2021 and a hernia operation in 2023, and uses a wheelchair due to hip and knee pain.

He has always left open the option of resigning if his health declined, following the example set by his predecessor, Benedict XVI, but had repeatedly dismissed the idea before his admission to hospital.

E.Scozzafava--INP