VATICAN CITY (AP) — Pope Francis made a surprise entrance to St. Peter’s Square during a special Jubilee Mass for the sick and health workers on Sunday, marking his first public appearance at the Vatican since leaving t he hospital two weeks ago after a life-threatening bout with pneumonia.

The pontiff waved at the crowd of faithful that stood and applauded as he was pushed in a wheelchair unannounced to the front of the altar in the square. Some exclaimed, “I see the pope!″ as his image first emerged on a big screen showing him passing through the Holy Door before being brought down a ramp to the altar.

“Good Sunday to everyone,’’ Francis said, speaking into a microphone, which he tapped to make sure it was working on a second attempt. “Thank you very much.”

The pontiff’s voice sounded stronger than when he addressed well-wishers outside of Gemelli hospital on the day of his release March 23, after a five-week hospital stay.

He wore nasal tubes to receive supplemental oxygen, which the Vatican says is being gradually reduced. As he waved and blessed the crowd, his arm movements remained limited — which his doctor said was not related to his illness but to an unspecified trauma suffered before his Feb. 14 hospitalization.

After the Mass, the pontiff greeted some of those who assisted in the service, many who bowed to kiss his hands. He exited the square through the Holy Door.

Francis has just completed two weeks of at least two months of doctor-ordered rest as he continues physical, respiratory and speech therapy, as well as treatment for a lingering lung infection.

The pope referred to his experience with illness in both the traditional Sunday blessing and the homily read by Archbishop Rino Fisichella, organizer of the Holy Year that is expected to bring some 30 million pilgrims to Rome.

Addressing the sick among the crowd, the pope said in the homily read by Fisichella that “In this moment of my life I share a lot: the experience of infirmity, feeling weak, depending on the others for many things, needing support.

“It is not easy, but it is a school in which we learn every day to love and to let ourselves be loved, without demanding and without rejecting, without regretting, without despairing, grateful to God and to our brothers for the good that we receieve, trusting for what is still to come.″

He also urged the faithful not to push the fragile from their lives “as unfortunately a certain mentality does today. Let’s not ostracize pain from our surroundings. Let’s instead make it an opportunity to grow together, to cultivate hope.″

In the traditional Sunday blessing, he offered prayers for doctors, nurses and health care workers “who are not always helped to work in inadequate conditions, at times the victims of aggression. Their mission is not easy and must be supported and respected.″

The faithful were moved by the pope’s unexpected appearance.

’’It was beautiful, something completely unexpected because I didn’t think I would see the pope,″ said Pasquale Citrolo from Trapani, Sicily. “Instead he gave us this gift.″

Linda Elezi, from the Adriatic coastal province of Ancona, said she was touched by the pope’s “surprise.″

“We pray for him every day, and he prays for us, and for peace and for all the wold, because that is the message of our pilgrimage today: Bring peace to all the world,″ she said.

Barry reported from Milan.

ROME (AP) — Pope Francis has shown ‘’a truly surprising improvement’’ since returning to the Vatican to convalesce after surviving a life-threatening bout with double-pneumonia, the doctor who coordinated the pontiff’s five-week hospitalization said Saturday.

“I find him very lively,’’ Dr. Sergio Alfieri said, after visiting the pope at his apartment in the Santa Marta Domus on Wednesday, three days after his release from Rome’s Gemelli hospital. “I believe that he will return if not to 100%, 90% of where he was before.’’

Francis appeared frail and weak as he greeted a crowd of well-wishers from a hospital balcony on Sunday. His voice was waning as he praised a woman in the crowd for bringing yellow flowers. He was able to only partially lift his arm to bless the people and he gasped for air as he was wheeled back inside.

Alfieri said the pope’s voice was regaining strength, and that his reliance on supplemental oxygen has decreased. The limited mobility of his arm was due to an unspecified trauma he sustained before being hospitalized, and that will take time to heal, Alfieri said.

The 88-year-old pope was hospitalized on Feb. 14 after a long bout with bronchitis that left him breathless at times, and which quickly developed into double pneumonia and revealed a polymicrobial (viral, bacterial and fungal) respiratory infection. Throughout the ordeal, doctors emphasized the complexity of his condition, given his age, lack of mobility requiring a wheelchair, and the removal of part of a lung as a young man.

Alfieri repeated that he didn’t think the pope would make it after a severe respiratory crisis a week after being hospitalized, and he informed the pope that a “decisive” treatment necessary to save him would put his organs at risk.

’He gave his consent, and then he looked a Massimiliano Streppetti, whom he named his personal health assistant who assumed the responsibility, to say, ‘We approve everything,’ also at the price of coming out with damaged kidneys or bone marrow that produces damaging red blood cells,’’ said Alfieri.

Alfieri preferred to describe the treatment as “decisive,’’ and not aggressive, and emphasized that no extraordinary, life-extending measures were ever taken. The Feb. 22 incident was one of several critical moments when the pope’s life hung in the balance, the doctor said.

While Francis beat the double pneumonia in the hospital, Alfieri said he is continuing to treat the fungal infection, which he said will take months to resolve. The pope is also receiving physical, respiratory and speech therapy.

Alfieri continues to consult the pope’s personal medical team daily, and will visit Francis in the Vatican every week.

The pope demonstrated his trademark humor in this week’s visit, responding to a comment by Alfieri that the 88-year-old pontiff had the mentality of a 50- or 60-year-old. “As I leaned in, he said, ‘Not 50, 40,‘’’ Alfieri recalled. “So his good sense of humor is back.’’

Doctors have ordered the pope to rest for at least two months and to avoid crowds. But after seeing the pope’s improvements and knowing his work ethic, Alfieri warned that “if he recovers so quickly, they will have to put on the brakes.’’

ROME (AP) — Pope Francis’ medical team briefly considered suspending treatment after a Feb. 28 breathing crisis but instead decided on an aggressive course that put his organs at risk, the doctor coordinating the pope’s hospital care said in an interview published Tuesday.

Dr. Sergio Alfieri said the 88-year-old pontiff and people close to him alike understood “that he might not survive the night,’’ after the bronchospasm attack during which the pope inhaled vomit.

“We needed to choose whether to stop and let him go, or to push it and attempt with all of the possible drugs and the treatments, taking the very high risk of damaging other organs,’’ Alfieri told told the Milan daily Corriere della Sera. “In the end, that is the path we chose.”

Francis was released Sunday after 38 days of treatment for double pneumonia, under doctors’ orders to observe two months of convalescence during which he should avoid large gatherings. The pope appeared weak and frail when he greeted the crowd outside the Gemelli hospital before his discharge.

The Vatican has said it is not clear if the pope will meet with King Charles III on a Vatican state visit next month, or any Holy Week activities leading up to Easter on April 20.

Alfieri said that the pope remained “alert’’ throughout the Feb. 28 ordeal and that his personal health care assistant, Massimiliano Strappetti, “who knows perfectly the pontiff’s wishes,’’ urged them “to try everything. Don’t give up.”

Alfieri acknowledged that the treatment risked damaging the pope’s kidneys and bone marrow, “but we continued, and his body responded to the treatments and the lung infection improved.’’

The medical bulletin that night said that the pope had suffered a bronchiospasm so severe that he inhaled vomit “worsening his respiratory picture.” Doctors used a non-invasive aspiration to clear his airways.

Three days later, in a second life-and-death crisis, the pope suffered a pair of acute bronchiospasms episodes. Doctors used a camera tube with a device to remove mucus plus that yielded abundant secretions. The bulletin emphasized that the pope “always remained alert, oriented and collaborative.’’

Alfieri said he believed that prayers for the pope help keep him alive, something that the doctor said is backed by scientific literature.

“In this case the whole world was praying. I can say that twice the situation was lost, and then it happened like a miracle,’’ the doctor said, adding that “of course he was a very cooperative patient.’’

VATICAN CITY (AP) — A frail Pope Francis returned to the Vatican on Sunday after a five-week hospitalization for life-threatening double pneumonia, and he made a surprise stop at his favorite basilica on the way home before beginning two months of prescribed rest and recovery.

The 88-year-old pope sat in the front passenger seat of his white Fiat 500L wearing nasal tubes to give him supplemental oxygen as he entered the Perugino gate of Vatican City, where his return brought relief after fears that his illness could be fatal or lead to another papal resignation.

Francis’ motorcade from Gemelli hospital overshot the Vatican initially and took a detour across town to stop at St. Mary Major basilica, where the pope’s favorite icon of the Madonna is located and where he always goes to pray after a foreign visit.

He didn’t get out of the car but gave a bouquet of flowers to the basilica’s cardinal to place in front of the Salus populi Romani icon. The Byzantine-style painting on wood is revered by Romans and is so important to Francis that he has chosen to be buried in the basilica to be near it.

The tour through Rome’s historic center came after Francis made his first appearance in five weeks to give a thumbs-up and brief blessing from a hospital balcony. Hundreds of people had gathered on a brilliant spring Sunday morning to say goodbye and catch a first glimpse of Francis, who seemed to be gasping for air.

“I see this woman with the yellow flowers. Brava!” a bloated-looking Francis said in a breathless voice. He gave a weak sign of the cross before being wheeled back inside.

Chants of “Viva il papa!” and “Papa Francesco” erupted from the crowd, which included patients who had been wheeled outside just to catch his brief appearance.

Doctors say Francis needs two months of rest and convalescence at the Vatican, during which he should refrain from meeting with big groups of people or exerting himself. But they said he should be able to resume all his normal activities eventually.

His return home, after the longest hospitalization of his 12-year papacy and the second-longest in recent papal history, brought tangible relief to the Vatican and Catholic faithful who have been anxiously following 38 days of medical ups and downs and wondering if Francis would make it.

“Today I feel a great joy,” said Dr. Rossella Russomando, who was at Gemelli on Sunday but did not treat Francis. “It is the demonstration that all our prayers, all the rosary prayers from all over the world, brought this grace.”

The Rev. Enzo Fortunato, who heads a papal committee dedicated to children, said it was clear that Francis was happy to return home and would surely improve, especially after receiving so many get-well cards from children from around the world.

“If the first medicine was the affection of the children, the second medicine is definitely (going) home,” Fortunato said. “It will certainly speed up his recovery.”

At the Vatican, where a Holy Year is under way, pilgrims cheered and applauded when Francis’ greeting from Gemelli was broadcast live on giant TV screens in St. Peter’s Square.

“For me it was an important emotional experience to see him, because many people were waiting for this moment,” said Sister Luisa Jimènez, a nun from Francis’ native Argentina.

Another nun from the same order, Colombian Sister Angel Bernal Amparo, expressed concern, given his bloating and inability to speak much.

“He didn’t look well,” she said. “He couldn’t (talk) and I realized it was because of his breathing and, well, he left right there. But I was glad to have seen him.”

No special arrangements have been made at the Domus Santa Marta, the Vatican hotel where Francis lives in a two-room suite on the second floor next to the basilica. He will have supplemental oxygen and 24-hour medical care as needed, although his personal physician, Dr. Luigi Carbone, said he hoped Francis would progressively need less and less assistance breathing as his lungs recover.

The Argentine pope, who has chronic lung disease and had part of one lung removed as a young man, was admitted to Gemelli on Feb. 14 after a bout of bronchitis worsened.

Doctors first diagnosed a complex bacterial, viral and fungal respiratory tract infection and soon thereafter, pneumonia in both lungs. Blood tests showed signs of anemia, low blood platelets and the onset of kidney failure, all of which later resolved after two blood transfusions.

The most serious setbacks began Feb. 28, when Francis experienced an acute coughing fit and inhaled vomit, requiring the use of a noninvasive mechanical ventilation mask to help him breathe. He suffered two more respiratory crises a few days later, which required doctors to manually aspirate “copious” amounts of mucus from his lungs, at which point he began sleeping with the ventilation mask at night to help his lungs clear the accumulation of fluids.

He was never intubated and at no point lost consciousness. Doctors reported he always remained alert and cooperative, although they say he has probably lost a bit of weight given a natural loss of appetite.

“Unfortunately yes, there was a moment when many were saying that he might not make it. And it was painful for us,” said Mario Balsamo, the owner of coffee shop in front of Gemelli. “Instead, today with the discharge, we are very happy that he is well and we hope he will recover soon and will recover his strength.”

Dr. Sergio Alfieri, the medical and surgical chief at Gemelli who coordinated Francis’ medical team, stressed that not all patients who develop such a severe cases of double pneumonia survive, much less are released from the hospital. He said Francis’ life was at risk twice, during the two acute respiratory crises, and that the pope at the time understandably lost his typical good sense of humor.

“But one morning we went to listen to his lungs and we asked him how he was doing. When he replied, ‘I’m still alive,’ we knew he was OK and had gotten his good humor back,” he told a news conference late Saturday.

Alfieri confirmed that Francis was still having trouble speaking due to the damage to his lungs and respiratory muscles. But he said such problems were normal, especially in older patients, and predicted his voice would eventually return. Francis is also continuing to take medication to treat a more minor respiratory infection.

Vatican spokesman Matteo Bruni declined to confirm any upcoming events, including a scheduled audience on April 8 with King Charles III or Francis’ participation in Easter services at the end of the month. But Carbone said he hoped Francis might be well enough to travel to Turkey at the end of May to participate in an important ecumenical anniversary.

Only St. John Paul II recorded a longer hospitalization in 1981, when he spent 55 days at Gemelli for minor surgery and treatment of an infection.

Associated Press writers Silvia Stellacci and Giada Zampano in Rome and Colleen Barry in Soave, Italy, contributed.

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

ROME (AP) — Pope Francis will be released from hospital on Sunday after 38 days battling a severe case of pneumonia in both lungs that threatened his life on two occasions when he suffered acute respiratory crises, his doctors said Saturday.

Dr. Sergio Alfieri, who coordinated Francis’ medical team at Rome’s Gemelli hospital, said Francis will require at least two months of rest and rehabilitation as he continues recovering back at the Vatican. But his personal doctor, Dr. Luigi Carbone, said if he continues his steady improvements to date, he should be able to resume his normal activity.

The doctors spoke at a hastily-called press conference Saturday evening in the Gemelli hospital atrium, their first in-person update on the pontiff’s condition in a month.

They provided details on the severity of the infection, which he is still being treated for, and the two respiratory crises that marked the gravest threats to his life. They confirmed he would be released Sunday, after first offering a blessing to the faithful from his hospital suite, the first time he will have been seen by the public since he was admitted Feb. 14.

“When he was in really bad shape, it was difficult that he was in good spirits,” Alfieri said. “But one morning we went to listen to his lungs and we asked him how he was doing. When he replied, ‘I’m still alive’ we knew he was OK and had gotten his good humor back.”

Alfieri confirmed that Francis was still having trouble speaking due to the damage to his lungs and the time he spent on supplemental oxygen and ventilation. But he said such problems were normal and predicted his voice would return.

“When you have a bilateral pneumonia, your lungs get damaged and the respiratory muscles are in difficulty. You lose your voice a bit, like when you speak to high,” Alfieri said. “As for all patients, young or old but especially older ones, you need time for it to come back as it was.”

The Argentine pope, who has chronic lung disease and had part of one lung removed as a young man, was admitted to hospital after a bout of bronchitis worsened.

Doctors first diagnosed a complex bacterial, viral and fungal respiratory tract infection and soon thereafter, pneumonia in both lungs. Blood tests showed signs of anemia, low blood platelets and the onset of kidney failure, all of which later resolved after two blood transfusions.

The most serious setbacks began on Feb. 28, when Francis experienced an acute coughing fit and inhaled vomit, requiring he use a noninvasive mechanical ventilation mask to help him breathe. He suffered two more respiratory crises on March 3, which required doctors manually aspirate the mucus, at which point he began sleeping with the ventilation mask at night to help his lungs clear the accumulation of fluids.

At no point did he lose consciousness, and doctors reported he always remained alert and cooperative.

Over the past two weeks, he has stabilized and registered slight improvements. He no longer needs to wear the ventilation mask at night, and is cutting back his reliance on high flows of supplemental oxygen during the day.

At his home in the Santa Marta hotel, next to St Peter’s Basilica, Francis will have access to supplemental oxygen and 24-hour medical care as needed, Carbone said.

“The Holy Father is improving, and we hope soon he can resume his normal activity,” Carbone said.

The Vatican spokesman, Matteo Bruni, declined to confirm any upcoming events, including a scheduled audience April 8 with King Charles III or Francis’ participation in Easter services at the end of the month. But Carbone said he hoped Francis might be well enough to travel to Turkey at the end of May to participate in an important ecumenical anniversary.

The Vatican announced that before returning to the Vatican, Francis would appear on Sunday morning to bless faithful from his 10th floor suite at the hospital. While Francis released an audio message on March 6 and the Vatican distributed a photo of him March 16, Sunday’s blessing will be the first live appearance since Francis was admitted for what has become the longest hospitalization of his 12-year papacy.

ROME (AP) — The Vatican on Sunday released the first photograph of Pope Francis in more than a month, showing the pontiff in a three-quarter view from behind wearing a purple stole typical of Lenten liturgical vestments and sitting in a wheelchair before the altar of his personal hospital chapel.

The Vatican said he was participating in the celebration of the Mass with other priests in the 10th-floor papal apartment in the Gemelli hospital. No one else is visible in the photo and it is the first mention the Vatican has made of the pope’s participation in celebrating Mass since his Feb. 14 hospitalization for a bout with chronic bronchitis that quickly turned into double pneumonia.

There was no obvious sign that he was receiving supplemental oxygen mentioned in medical bulletins.

Doctors this week said the pontiff was no longer in critical, life-threatening condition, but they have continued to emphasize that his condition remained complex due to his age, lack of mobility and the loss of part of a lung as a young man. In an audio recording released March 6, the pope spoke in a feeble and labored voice as he thanked the faithful in St. Peter’s Square for their prayers.

His condition has been gradually improving over the last week, leading the Vatican to suspend morning updates and to issue less frequent medical bulletins. An X-ray this week confirmed that the infection was clearing.

In the most recent bulletin on Saturday, doctors said they were working to reduce the pope’s reliance on a non-invasive ventilation mask at night, which will allow his lungs to work more. He was continuing to receive high-flow supplemental oxygen, delivered by a nasal tube, during the day — although no such apparatus was evident in the photograph.

Earlier Sunday, dozens of children — many from war-torn countries, and toting yellow and white balloons — gathered outside Rome’s Gemelli hospital to greet Francis on his fifth Sunday hospitalized. While the pope did not appear from the 10th-floor suite of windows, he thanked them and acknowledged their presence in the traditional Sunday blessing.

“I know that many children are praying for me; some of them came here today to Gemelli as a sign of closeness,’’ the pontiff said in the Angelus text prepared for the traditional prayer but not delivered live again. “Thank you, dearest children! The pope loves you and is always waiting to meet you,’’ Francis said.

The Rev. Enzo Fortunato, president of the pontifical committee for World Children’s Day who organized the event, said that the gathering of children with their parents was a form of spiritual medicine for the 88-year-old pontiff. He called it “the most beautiful caress.’’

“The children represent a symbolic medicine for Pope Francis,’’ Fortunato said. “Letting him know that so many children are here for him cheers the heart.’’

A small group of children, whose balloons represented the colors of the Vatican flag, briefly entered the hospital to leave behind their drawings, messages and flowers for Francis. Many of the children came from poorer Italian districts or from countries impacted by war, some having arrived in Italy from Afghanistan and Syria via humanitarian corridors set up by the Sant’Egidio charity in agreement with the Italian government; others were from Ukraine, Gaza, South America and Africa.

One of them was 12-year-old Anastasia, who got up at 5 a.m. to make the trip from Naples with the hopes of delivering the message directly to the pope. “I wrote, ‘Pope Francis, get well and return home soon,’” she said. “We love you, all of the children are praying for you.’’

Andrea Iacomini, the spokesman for UNICEF in Italy, said besides demonstrating affection for the pope, the group also wanted to say “enough″ to conflicts that are impacting 500 million children in 59 countries.

“This pope is not just a religious leader, he is a great global leader. A man of peace. This pope is pope of the children.″ Iacomini said.

Francis typically delivers the Angelus from a window overlooking St. Peter’s Square to the gathered faithful, who have grown more numerous due to the Jubilee year that Francis inaugurated in December.

In the written text, Francis said he was thinking of others, who like him, are in a fragile state. “Our bodies are weak, but even like this, nothing can prevent us from loving, praying, giving ourselves, being for each other, in faith, shining signs of hope,’’ the pope said.

Along with a stop at St. Peter’s to seek indulgences by walking through the basilica’s Holy Door, pilgrims are now also adding a stop at Gemelli, a 15-minute train ride from the Vatican.

Francis has not been seen publicly since he was admitted to the hospital after a bout of bronchitis that made it difficult for him to speak. Doctors soon added a diagnosis of double pneumonia and a polymicrobial (bacterial, viral and fungal) infection.

The first three weeks of his hospitalization were marked by a rollercoaster of setbacks, including respiratory crises, mild kidney failure and a severe coughing fit. Over the the last week, his condition has stablized.

The next medical update won’t be issued until mid-week, the Vatican said.

Associated Press video journalist Francesca Primavilla contributed to this report.

ROME (AP) — Pope Francis was in stable condition Tuesday and breathing with just the help of supplemental oxygen after respiratory crises a day earlier, but will resume using a ventilation mask at night, the Vatican said.

In its late update, the Vatican said Francis had no further respiratory episodes during a day spent praying, resting and undergoing respiratory physiotherapy to try to help him fight double pneumonia.

The 88-year-old pope, who has chronic lung disease and had part of one lung removed as a young man, had two respiratory crises on Monday in a setback to his recovery.

Doctors extracted “copious” amounts of mucus from his lungs. They put him on a noninvasive mechanical ventilation mask to help him breathe and he slept with it through the night, but was stable enough on Tuesday morning to use just high flows of supplemental oxygen delivered by a nasal tube.

Doctors planned to resume using the mask while he sleeps Tuesday night, so that oxygen is pumped into his lungs via a mask that covers his nose and mouth.

Doctors said his clinical condition was stable and that his prognosis remained guarded, meaning he is not out of danger.

Francis’ medical team has not provided an in-person update on his condition since Feb. 21, a sign of the up-and-down nature of his hospitalization, which began on Feb. 14 and is the longest of his 12-year papacy.

On Tuesday, a group of Argentines from the country’s embassies in Rome brought a statue of Our Lady of Lujan to the Gemelli hospital to pray for Francis. The Argentine pope is particularly devoted to the blue veiled Lujan Madonna, which has been revered in Argentina since the 17th century.

“I am very happy to be now close to him,” said the Rev. Fernando Laguna, parish priest of the Argentine church in Rome. “I would like to hug him, but it’s not possible, but he told us that a prayer is like a hug So I am happy despite the pain.”

Francis’ treatment comes as the Vatican prepares for Lent, the solemn period leading up to Easter on April 20. As it is, a cardinal has been designated to take Francis’ place this week on Ash Wednesday, which opens Lent with a traditional service and procession in Rome. The pope was also supposed to attend a spiritual retreat this coming weekend with the rest of the Holy See hierarchy.

On Tuesday, the Vatican said the retreat would go ahead without Francis but in “spiritual communion” with him. The theme, selected weeks ago and well before Francis got sick, was “Hope in eternal life.”

Francis, who is not physically active, uses a wheelchair and is overweight, had been undergoing respiratory physiotherapy to try to improve his lung function. The accumulation of secretions in his lungs was a sign that he doesn’t have the muscle tone to cough vigorously enough to expel the fluid.

Doctors often use noninvasive ventilation to stave off intubation or the use of more invasive mechanical ventilation. Francis has not been intubated during this hospitalization. It’s not clear if he has provided any instructions on the limits of his care if he declines seriously or loses consciousness.

Catholic teaching holds that life must be defended from conception until natural death. It insists that chronically ill patients, including those in vegetative states, must receive “ordinary” care such as hydration and nutrition, but “extraordinary” or disproportionate care can be suspended if it is no longer beneficial or is only prolonging a precarious and painful life.

Francis articulated that in a 2017 speech to a meeting of the Vatican’s bioethics think tank, the Pontifical Academy for Life. He said there was “no obligation to have recourse in all circumstances to every possible remedy.” He added: “It thus makes possible a decision that is morally qualified as withdrawal of ‘overzealous treatment.’”

Paolo Santalucia contributed.

ROME (AP) — Pope Francis suffered two new episodes of acute respiratory crises Monday and was put back on noninvasive mechanical ventilation, the Vatican said.

Francis had inhaled “copious” amounts of mucus in another setback in what has become a more than two-week battle to overcome a complex respiratory infection and pneumonia.

In a late update, the Vatican said the episodes were caused by a “significant accumulation” of mucus in his lungs and bronchial spasms. “Two bronchoscopies were performed with the need for aspiration of copious secretions,” the Vatican said.

Francis remained alert, oriented and cooperated with medical personnel. The prognosis remained guarded.

Earlier Monday, Pope Francis issued a new message from the hospital as Vatican officials begged him to let his voice be heard after disappearing from public view for over two weeks as he recovers.

Francis, 88, denounced the “progressive irrelevance” of international organizations to combat war as he remained at Rome’s Gemelli hospital in stable condition. He was up, had breakfast and was receiving therapies after sleeping “well all night long,” the Vatican said.

The Vatican hasn’t released any photos or videos of Francis since before he entered the hospital on Feb. 14 with a complex lung infection. This has become the longest absence of his 12-year papacy.

The Vatican has provided brief, twice-daily medical updates on his condition, and Francis has begun signing off on documents with “From Gemelli Polyclinic” in an indication that he is up and working.

The Vatican has defended Francis’ decision to recover in peace and out of the public eye. But on Monday one of Francis’ closest friends at the Vatican, Archbishop Vincenzo Paglia, urged him to let his voice be heard, saying the world needs to hear it.

“We need men like him who are truly universal and not only one-sided,” Paglia said, speaking after a press conference to launch the annual assembly of his Pontifical Academy for Life, the Vatican’s bioethics academy, which has as this year’s theme “The End of the World?”

Francis wrote a message to the assembly, dated Feb. 26, in which he lamented that international organizations are increasingly ineffective to combat the threats facing the world and are being undermined by “short-sighted attitudes concerned with protecting particular and national interests.”

It’s a theme he has articulated before. Francis also has repeatedly called for peace between Russia and Ukraine while trying to maintain the Vatican’s traditional diplomatic neutrality, and has tried to achieve a similar balancing act for Israel’s war with Hamas in Gaza.

Even a Vatican ambassador not especially close to Francis, Archbishop Georg Gaenswein, said the faithful needed to hear his voice at a time when war is raging in Europe. Gaenswein was Pope Benedict XVI’s longtime secretary, and Francis exiled him to be the Vatican ambassador in the Baltics after he published a memoir in 2023 that was critical of Francis.

“Pope Francis’ voice is of vital importance for all the world because he’s the only authority who speaks of peace, who condemns war, all the wars under way starting with Ukraine,” La Repubblica quoted Gaenswein as saying.

Francis’ 17-night hospitalization is by no means reaching the papal record that was set during St. John Paul II’s numerous lengthy hospitalizations over a quarter century.

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

ROME (AP) — A stable Pope Francis had a visit Sunday from the Vatican secretary of state as he continued his recovery from double pneumonia, the Vatican said, but again skipped his weekly noon blessing to avoid even a brief public appearance from the hospital.

Instead, the Vatican distributed a message from the pope in which he thanked his doctors for their care and well-wishers for their prayers, and prayed again for peace in Ukraine and elsewhere.

“From here, war appears even more absurd,” Francis said in the message, which he drafted in recent days from the Gemelli hospital, the Vatican said. Francis said he was living his hospitalization as an experience of profound solidarity with people who are sick and suffering everywhere,

“I feel in my heart the ‘blessing’ that is hidden within frailty, because it is precisely in these moments that we learn even more to trust in the Lord,” Francis said in the text. “At the same time, I thank God for giving me the opportunity to share in body and spirit the condition of so many sick and suffering people.”

It marked the third weekend in a row that Francis has canceled the Sunday appointment delivering the Angelus prayer in person. He could have done so from his 10th floor hospital suite at the Gemelli hospital if he were well enough.

But many signs indicated he was recovering and improving. “The night was quiet, the pope is still resting,” the Vatican said in its Sunday update.

Cardinal Pietro Parolin and his chief of staff, Archbishop Edgar Pena Parra, called on the pope Sunday morning, their second visit since Francis’ Feb. 14 hospitalization, according to the Vatican spokesman, Matteo Bruni. There were no details of what was discussed, but the mere visit suggested Francis’ condition was stabilizing.

“The night was quiet, the pope is still resting,” the Vatican said in its Sunday early update.

He had no fever or signs of elevated white blood cells, which would signal his body was still fighting an infection.

Doctors on Saturday reported that Francis was in stable condition, with no mention of him being critical. Their upbeat assessment came a day after a respiratory crisis that resulted in him being put on noninvasive mechanical ventilation.

But the 88-year-old pope had a “good response” in his gas exchange levels even during the “long periods” he was off the ventilator mask Saturday and only using high-flow supplemental oxygen, the Vatican said.

The fact that Francis was able to use just high-flow oxygen for long periods, without any significant effect on the levels of oxygen in his blood, was a sign his respiratory function was improving.

Doctors were cautious however and kept his prognosis as guarded, meaning he wasn’t out of danger. He was eating and drinking and continued his respiratory physiotherapy, and spent 20 minutes in his private chapel down the hall on Saturday, the Vatican said.

The pope, who had part of one lung removed as a young man, has lung disease and was admitted to Gemelli on Feb. 14 after a bout of bronchitis worsened and turned into a complex pneumonia in both lungs.

Francis’ hospitalization has come as the Vatican is marking its Holy Year, drawing pilgrims to Rome from all over. They are walking through the Holy Door at St. Peter’s Basilica and also making pilgrimages to the hilltop Umbrian town of Assisi, to pray at the home of Francis’ namesake, St. Francis.

“Every day we’re praying for the pope,” said the Rev. Jacinto Bento, a priest visiting Assisi on Saturday with a group of 30 Jubilee pilgrims from the Azores Islands. “We’re very sad for his situation.”

In an odd coincidence, Francis was supposed to have presided Saturday over a Holy Year audience in the Vatican’s auditorium for the staff of the Gemelli hospital and other health care workers. They came as planned and completed the pilgrimage, while Francis continued his recovery at the hospital.

“We thought we would be able to meet him this morning in Paul VI Hall for the Jubilee Catechesis, but he surprised us by coming to us,” said Monsignor Claudio Giuliodori, spiritual guide of the Catholic University of the Sacred Heart, of which Gemelli is a part.

Giovanni Frisullo, a Gemelli neurologist, said the atmosphere at Gemelli was one of tension and prayer. “There is a situation of waiting but also of hope,” he said.

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ROME (AP) — Pope Francis remained in stable condition Saturday a day after a respiratory crisis during his battle with double pneumonia, the Vatican said. He spent long periods of the day off the noninvasive mechanical ventilation he initially needed in a sign that his lung function was improving.

Francis had no further episodes of bronchial spasms like the one he suffered Friday, in which he inhaled vomit during a coughing fit. He had no fever and no signs of new infection, was feeding himself solid food and coffee for breakfast, and continued his respiratory physiotherapy, the Vatican said.

The 88-year-old pope had a “good response” in his gas exchange levels even during the “long periods” he was off the ventilator mask and only using high-flow supplemental oxygen. But his prognosis remained guarded, meaning he wasn’t out of danger.

“The Holy Father is always vigilant” and aware of what’s going on around him, the statement said, adding that he received the Eucharist and spent 20 minutes in prayer in the private chapel down the hall from his 10th floor hospital room.

The comparatively positive update came after Francis suffered a setback Friday in his two-week battle against pneumonia.

After the bronchial spasm, doctors aspirated the vomit and placed Francis on noninvasive mechanical ventilation, a mask that pumps oxygen into his lungs. Doctors said episode resulted in a “sudden worsening of the respiratory picture.”

The pope remained conscious and alert at all times and cooperated with the maneuvers to help him recover.

The fact that Francis on Saturday was able to use just high-flow oxygen for long periods, without any significant effect on the levels of oxygen in his blood, was a sign his respiratory function was improving.

The pope, who had part of one lung removed as a young man, has lung disease and was admitted to Gemelli after a bout of bronchitis worsened and turned into pneumonia in both lungs.

Doctors not involved in Francis’ care said Friday’s episode was particularly alarming given his existing lung disease and overall fragility.

Types of noninvasive ventilation include a BiPAP machine, which helps people breathe by pushing air into their lungs. Doctors will often try such a machine for a while to see if the patient’s blood gas levels improve so they can avoid the more invasive intubation ventilation and eventually go back to using supplemental oxygen alone.

Doctors did not resume referring to Francis being in “critical condition,” which has been absent from their statements for four days now. But they say he isn’t out of danger, given the complexity of his case.

Francis’ hospitalization has come as the Vatican is marking its Holy Year that is drawing pilgrims to Rome from all over. They are walking through the Holy Door at St. Peter’s Basilica and also making pilgrimages to the hilltop Umbrian town of Assisi, to pray at the home of Francis’ namesake, St. Francis.

“Every day we’re praying for the pope,” said the Rev. Jacinto Bento, a priest visiting Assisi on Saturday with a group of 30 Jubilee pilgrims from the Azores Islands. “We’re very sad for his situation.”

Serena Barbon, visiting Assisi from Treviso on Saturday with her husband and three children, said she hoped that if Francis doesn’t make it, the next pope will be just like him.

“He’s been very charismatic and we pray for him and that any new pope might also be someone who puts the poor in the center. Because we’re all a bit the poor,” she said.

In an odd coincidence, Francis was supposed to have presided Saturday over a Holy Year audience in the Vatican’s auditorium for the staff of the Gemelli hospital and other healthcare workers. They came as planned and completed the pilgrimage, walking through the Holy Door of St. Peter’s Basilica, while Francis continued his recovery at the hospital.

“We thought we would be able to meet him this morning in Paul VI Hall for the Jubilee Catechesis, but he surprised us by coming to us,” said Monsignor Claudio Giuliodori, spiritual guide of the Catholic University of the Sacred Heart, of which Gemelli is a part.

Giovanni Frisullo, a Gemelli neurologist, said the atmosphere at Gemelli was one of tension and prayer. “There is a situation of waiting but also of hope,” he said.

Dell’Orto reported from Assisi, Italy. Paolo Santalucia contributed from Rome. Associated Press writer Carla K. Johnson in Washington state contributed to this report.