What to know about Pope Francis' medical condition

Pope Francis has been an active pontiff during his tenure, traveling across the globe multiple times since being elected in 2013. But in recent years, he has struggled with health challenges and was recently hospitalized. On Tuesday night, the Vatican announced the 88-year-old pope had bilateral, or double, pneumonia.

Newsday spoke with local doctors about the pope’s condition, what kind of treatments he might receive and his long recovery ahead.

The pope has bilateral pneumonia. What does that mean?

Pneumonia is a lung infection, according to the U.S. Centers for Disease Control and Prevention. It can be caused by germs including bacteria, viruses, fungi and parasites. Bilateral pneumonia means an individual has infections in both of their lungs.

In 2023, 41,210 people in the United States died of pneumonia, a rate of 12.3 per 100,000 people, according to the CDC. People 65 and over, as well as children under the age of 5, are at a higher risk of having pneumonia and being severely ill. Smoking cigarettes and excessive consumption of alcohol can also increase the risk of developing pneumonia, the agency said.

Does the pope have an underlying condition that makes him more vulnerable to pneumonia?

Yes. When he was in his 20s, part of his right lung was removed after a serious respiratory infection.

"This definitely affects the lung’s ability to function well and decreases his overall ability to breathe," Dr. Mangala Narasimhan, a pulmonologist and director of Critical Care Services for Northwell Health, said. "His ability to clear carbon dioxide is down overall as compared to someone with healthy lungs."

Dr. Alan Bulbin, infectious disease director at Catholic Health’s St. Francis Hospital in Flower Hill said: "You’re talking about somebody with pulmonary lung compromise, so that puts them in a higher risk category for both upper and lower respiratory tract infections."

How did the pope get pneumonia?

The Vatican said Pope Francis has a "polymicrobial infection which arose on a background of bronchiectasis and asthmatic bronchitis."

Polymicrobial infection means he may have more than one bacteria or a mix of bacteria and viruses that are causing the infection, Narasimhan said.

"Bronchiectasis is a lung disease that occurs over time and reduces clearance of the lungs," she said. Mucus can build up and bacteria could have the chance to grow. The airways can get scarred and enlarged, which can lead to more infections.

Exposure to allergens or irritants can cause asthmatic bronchitis which inflames the bronchial tubes.

Bulbin said pneumonia can start with a respiratory virus like flu, RSV or COVID-19, as well as the common cold virus.

"Often those are just limited to your sinuses or throat but for someone like the pope, who has a preexisting lung condition, it gives these common viral pathogens easier access and spreads down into your lung," Bulbin said.

How serious is this condition for the pope?

"His immune system is probably not great, given his age and his lungs are not functioning well, given the fact that part of his lung was removed," Narasimhan said. "All combined together, this is a very serious prognosis for him."

Bulbin said an elderly person with a compromised lung and compromised immune system is more at risk for a bacterial infection once they are further weakened by a viral infection.

"That’s where things get more complicated, where you can have more than one pathogen and thereby call it a polymicrobial infection,"  Bulbin said. "And that’s when you have a more complicated pneumonia."

What are some of the treatments for his condition?

The Vatican said Pope Francis is receiving "cortisone antibiotic therapy." It wasn't clear what other medications or treatments he is receiving but it said the discovery of his double pneumonia will lead to a need for more medication.

Bulbin said if the initial virus or bacteria is identified early enough, there are medications that can treat them to head off more serious complications. 

Narasimhan said antibiotics and steroids are often used.

"It's a lot of chest physiotherapy, oxygen and sometimes a ventilator, if things get worse," she said.

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.