Pope Francis, battling double pneumonia, remains in a critical condition for a second day running and his prognosis is still guarded, the Vatican says.
The pope, 88, was admitted to Rome's Gemelli hospital on February 14 after experiencing difficulty breathing for several days and subsequently had pneumonia diagnosed in both lungs.
The Vatican first described his condition as critical on Saturday, reporting that Francis had needed supplemental oxygen and blood transfusions that day after a "prolonged asthma-like respiratory crisis".
"The condition of the Holy Father remains critical; however, since last night he has not experienced further respiratory crises," the Vatican said on Sunday.
Blood tests also indicated a "mild renal insufficiency, which is currently under control," it said.
"The complexity of the clinical picture, and the necessary wait for the pharmacological therapies to show some effect, require that the prognosis remains guarded," it said.
The statement described the pope as "alert and well-oriented" and said he was receiving "high-flow oxygen therapy" through a tube under his nose.
In a written message for his usual Sunday prayer in St Peter's Square, which the pope was unable to read out for a second consecutive week, Francis said he was continuing "confidently" with his treatment in hospital. He thanked his doctors and people who have sent him messages of support.
Archbishop Rino Fisichella, a senior Vatican official, told participants at a Mass in St Peter's Basilica on Sunday morning they should make their prayers for Francis "stronger and more intense".
The Diocese of Rome, which the pope leads, held a special Mass on Sunday evening to pray for Francis, so that he will have "the strength necessary to get through this moment of trial".
Double pneumonia is a serious infection that can inflame and scar both lungs, making it difficult to breathe. The Vatican has described the pope's infection as "complex", saying it is being caused by two or more microorganisms.
Francis, who has been pope since 2013, has suffered bouts of ill health in the past two years. He is particularly prone to lung infections because he developed pleurisy as a young adult and had part of one lung removed.
Near the Vatican on Sunday morning, pilgrims expressed concern for the pope's condition. Outside Gemelli hospital, groups of people were gathering to pray near a statue of the late Pope John Paul II, who was treated at the facility many times during his long papacy.
People were leaving flowers and notes for Francis, and lighting candles at the base of the late pope's memorial.
In a statement on Saturday evening, the Vatican said the pope had needed blood transfusions because tests showed he had a low platelet count, which is associated with anaemia. Platelets are cell fragments in our blood that form clots and stop or prevent bleeding.
In a briefing on Friday, two of his doctors said the pope was highly vulnerable because of his age and general frailty.
Dr Sergio Alfieri, a senior member of the Gemelli staff, said there was a risk the lung infection could spread to his bloodstream and develop into sepsis, which "could be very difficult to overcome".
