Pope Francis is reported to be "alert, focused, and cooperative" after suffering two episodes of acute respiratory failure on Monday afternoon, the Vatican said in a statement.

Doctors at Rome’s Gemelli Hospital intervened to clear mucus from the 88-year-old pontiff’s lungs, an update from the Holy See confirmed. While he had previously been receiving high-flow oxygen therapy, he has now resumed the use of a ventilator to assist his breathing.

This marks the third serious deterioration in the Pope’s health since he was admitted to hospital on February 14 with pneumonia. The Vatican had earlier reported that he responded well to oxygen therapy and was showing signs of improvement. However, on Friday, he suffered an "isolated" breathing crisis involving vomiting, leading to renewed concerns about his condition.

The Pope’s illness has prevented him from delivering his traditional Angelus prayer in person for three consecutive weeks, with the Vatican instead publishing written remarks from his hospital room. His most recent message, prepared in the past few days, expressed gratitude for the prayers and support he has received, as well as appreciation for his medical team.

Given his current state, Pope Francis will also be unable to lead the Ash Wednesday mass this week, marking the beginning of Lent.

Despite Vatican assurances that his condition remains stable, concerns persist among the faithful. Hundreds of Catholics gathered for an eighth evening in St Peter’s Square on Monday to pray for his recovery. Among them were priests, nuns, and pilgrims from various countries, with an American cardinal leading the prayers.

"I come every night to pray, but this night I am pretty worried," said Javier, a Romanian priest. "We still have hope, but it doesn’t look good."

Patricia, a Spanish Catholic from Toledo, expressed her concern as well. "It looks bad, and that's a shame because we really like Francis," she told the BBC. "He's really opened the doors of the church to many, like LGBT people. I think they will look for a more conservative pope next, to stop the change."

Supporters have also been visiting the hospital, hoping to catch a glimpse of the Pope at the window, as has happened in the past. However, officials say he remains too unwell to greet the public.

Pope Francis was initially treated for bronchitis before doctors confirmed pneumonia in both lungs. His vulnerability to respiratory illnesses stems from a bout of pleurisy in his youth, which led to the partial removal of one lung.