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Pope Francis greets visitors at the conclusion of his general audience in the Paul VI Audience Hall at the Vatican Feb. 12, 2025. (CNS photo/Lola Gomez)

LONDON (AP) — Vatican officials have said Pope Francis has developed pneumonia in both lungs, further complicating his recovery. The 88-year-old pontiff was hospitalized Friday after a weeklong bout of bronchitis worsened. On Monday, doctors said he had developed a mix of infections in his respiratory tract.

On Wednesday, the Vatican said Pope Francis “had a tranquil night, woke up and had breakfast,” saying he was in good spirits. Here’s what a pneumonia diagnosis can mean and what doctors will be looking out for in the coming days.

Pope Francis was admitted to Rome’s Gemilli hospital in a “fair” condition on Friday after his bronchitis worsened. On Monday, doctors said he had developed a polymicrobial respiratory tract infection, or a mix of viruses, bacteria and possibly other organisms growing in his respiratory tract.

Late Tuesday, the Vatican said a chest scan showed he had developed pneumonia in both lungs, requiring additional medication.

Bronchitis occurs when the airways in the lung, known as the bronchial tubes, become inflamed, leading to coughing and mucus production. That infection can sometimes spread to the lungs, resulting in pneumonia, an inflammation of the lungs.

Doctors say pneumonia in anyone can be serious, but for someone of the pope’s age, it’s potentially life-threatening.

“One of the risk factors for more serious infection (is) older age, meaning anyone over 65,” said Dr. Meredith McCormack, director of pulmonary and critical care medicine at Johns Hopkins University.

Even though the pope lost part of his right lung decades ago, McCormack said that shouldn’t necessarily compromise his recovery, adding that she would be more concerned about any possible signs of weakness in His Holiness.

“Being a more frail older person can increase your risk of having complications,” she said, noting that having to use a wheelchair could be considered a sign of frailty. The pope has relied on a wheelchair for more than two years.

It appears, however, that the pope is not bed-bound. He has been eating breakfast, is able to get out of bed and his heart function is good, according to a Vatican official.

All of those are “fabulous signs,” said Dr. Andrew Chadwick, a respiratory and intensive care specialist at Oxford University Hospitals, in Britain. “Every day he’s getting out of bed is a really good sign...that the outcome will be more positive.”

Beyond antibiotic drug therapy, there are multiple treatments available, including supplemental oxygen and therapies to support the lungs and body while it’s trying to recover. Steroids and antibiotics are likely the core elements of the pope’s care, alongside nursing care and chest physiotherapy.

Physiotherapy can help patients clear the fluids building up in their lungs, particularly if they aren’t very mobile themselves.

McCormack said that severe cases of pneumonia were typically treated for about one to two weeks but that recovery in an older person could extend beyond that.

Mainly, they’ll be hoping that the pope’s condition doesn’t deteriorate further.

“If he just stays as he is while he’s fighting off the infection and has a gradual recovery, that lack of worsening would be an encouraging sign,” McCormack said.

The next few days will be critical, according to Chadwick.

“What we hope (to see) is a kind of substantial improvement in the first 72 hours,” he said, adding that the next phase of recovery after that might be a bit slower in older people.

Dr. Maor Sauler, who specializes in adult pulmonary and critical care at Yale University, said that antibiotics need the lungs to be working to recover from infections like pneumonia, but the ability of lungs to recover diminishes with age.

“When anyone has pneumonia, there’s a good chance we can treat it,” he said. “However, it is also one of the leading causes of death. And so there are also situations where, despite our best efforts, we cannot clear the infection.”

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