Pope Francis' condition remained "critical" the evening of Feb. 23, his doctors said, with blood tests showing "initial, mild renal insufficiency, at present under control."

The pope has had "no further respiratory crisis since last night," said the medical bulletin published by the Vatican, but it said he was continuing to use supplemental oxygen through a nasal cannula.

A blood transfusion administered Feb. 22, the bulletin said, did prove beneficial "with a rise in the value of hemoglobin." However, it added, his platelet count was still low.

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The 88-year-old Pope Francis, who has been hospitalized at Rome's Gemelli hospital since Feb. 14 and has been diagnosed with double pneumonia, "continues to be alert and well oriented," it said.

But "the complexity of his clinical picture, and the need to wait for the drug therapies to provide some result, dictate that the prognosis remains reserved," the doctors said.

In the suite of rooms reserved for the popes on the 10th floor of the hospital, Pope Francis "participated in Holy Mass, together with those who are caring for him during these days of hospitalization," the bulletin said.

The pope's doctors said reported Feb. 22 that he had experienced "an asthmatic respiratory crisis of prolonged magnitude, which also required the use of oxygen at high flows."

The Vatican released a message written by the pope for the midday recitation of the Angelus prayer Feb. 23, but did not say what day the pope wrote it.

"I am confidently continuing my hospitalization," the pope wrote, "carrying on with the necessary treatment; and rest is also part of the therapy!"

Pope Francis thanked the doctors and health care workers for their care and also thanked people for the "many messages of affection" that he has received, particularly the letters and drawings sent by children.

"Thank you for this closeness and for the prayers of comfort I have received from all over the world," he wrote.

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Many of those prayers have come from people who gather in the courtyard beneath his suite of rooms at the hospital. The immense stone statue of St. John Paul II is the focal point where visitors gravitate to pray and leave flowers, candles, rosaries, cards, drawings and notes. A sun-worn pot of plastic poinsettias was brightened by newer offerings of magenta orchids, white cyclamens and red roses.

One man, who came from Naples Feb. 23 set five helium balloons tied to a weight by the statue, one with a glittering rainbow and the words, "Get well soon."

Sister Geneviève Jeanningros, a member of the Little Sisters of Jesus who sits in the front row most Wednesdays at Pope Francis' weekly general audience, was also among the few who were praying in the courtyard late that morning.

While there have been more journalists in the courtyard than faithful most days, that changed about 10 minutes before noon Feb. 23. More than 60 young people and members of a community connected with the Pontifical Academy of the Immaculate Conception arrived to pray the midday Angelus. They were joined later by Cardinal Angelo De Donatis, the head of the Apostolic Penitentiary and the pope's former vicar for the Diocese of Rome from 2017 to 2024.

Father Giacomo Martinelli, who heads the academy's pastoral initiatives and was leading the group, told reporters the pope needs everyone's prayers "like Jesus in Gethsemane."

"Prayer works. It is God's power," the priest said.

Cardinal De Donatis told reporters that this was a time "to intensify one's prayers" and to ask God to give the pope strength. "We're here to help him feel our closeness" and "this strong embrace."

A few dozen other people made their way to the courtyard and joined a Franciscan friar who led the singing of the Angelus and the recitation of the rosary with three nuns.

A mother and her daughter, both wearing heart-shaped sunglasses, knelt before the statue and set down four red and silver heart-shaped mylar balloons tied to a pot of flowers.

"Francis is the pope of the frail and the weak," said the mother, Violetta. Now that he has become weak, too, "being here seemed the right thing."

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She said she feels a special bond with Pope Francis because her daughter, Maria, was born around the same time the pope was elected in March 2013.

Many people had told Violetta that Maria would never be able to do many things because of her autism. "But she drew this!" the mother said, beaming, holding a drawing of the pope surrounded by people and the words, "Be strong Francis. We are with you." They hoped to somehow get the drawing to the pope.