ROME (AP) — Pope Francis’ respiratory infection is presenting a “complex clinical picture” that will require further hospitalization, the Vatican said Monday, as concerns grew about the increasingly frail health of the 88-year-old pontiff.

Vatican spokesman Matteo Bruni said the results of tests conducted in recent days and Monday indicate the pope is suffering from a polymicrobial respiratory tract infection that has necessitated a second change in his drug therapy since being hospitalized Friday. Scientists say polymicrobial diseases are caused by a mix of viruses, bacteria, fungi and parasites.

There was no timeframe given for his hospitalization, which at Day 4 has already sidelined Francis for longer than a 2023 hospitalization for pneumonia. Bruni said the complexity of his symptoms “will require an appropriate hospital stay.”

In a late update Monday, Bruni said Francis’ condition was “stationary,” and that he had resumed some work activities and reading.

Francis had part of one lung removed after a pulmonary infection as a young man and is prone to bouts of bronchitis in winter. He was admitted to Rome’s Gemelli hospital in a “fair” condition on Friday after a weeklong bout of bronchitis worsened. Doctors confirmed a respiratory tract infection and prescribed “absolute rest” alongside unspecified drug therapies. Subsequent updates said his slight fever had gone away and that he was in “stationary” condition.

Bruni said Francis ate breakfast, read the newspapers and received the Eucharist on Monday after a third peaceful night. And in a sign Francis was still keeping up with some of the essentials of his routine, the parish priest of the Catholic Church in Gaza, the Rev. Gabriel Romanelli, reported that Francis had maintained his daily video call to the church on Friday and Saturday night. He sent a text message on Sunday.

“We heard his voice. It’s true, it was more tired,” Romanelli told Vatican News. “But we heard his voice clearly and he listened to us,” said the Argentine priest, whom Francis has phoned every day of the Gaza war.

What is bronchitis?

Bronchitis, or an inflammation of the airwaves, can be relatively mild in a healthy person but can become much more severe in someone who is older or has existing lung problems, especially when they are unable to cough up and expel the accumulating mucus. Bacteria and other organisms can colonize, leading to further infection that may be harder to treat.

Dr. Maor Sauler, who specializes in adult pulmonary medicine and critical care at Yale School of Medicine, said it’s not uncommon for people suffering from bronchitis to develop an infection with more than one organism in their lungs. The concern, however, is that antibiotics and other drug therapies don’t work in isolation and require the body to respond, which given Francis’ other problems may make recovery more challenging.

“Being older, wheelchair-bound, all those are risk factors for a situation in which we can’t treat it despite our best efforts,” said Sauler, who is not involved in Francis’ care.

As people get older, their immune systems don’t work as well, making doctors especially concerned when elderly patients develop multiple problems. A decline in lung function and muscle strength can also impair the body’s ability to effectively clear respiratory secretions, increasing susceptibility to infections like pneumonia, a deeper and far more serious infection of the lungs’ air sacs.

“It’s in the public record that he’s had chest problems in the past, he’s been admitted to hospital with pneumonia (in 2023), he’s had part of one lung removed,” noted Dr. Nick Hopkinson, medical director of the Asthma + Lung UK foundation, who is not involved in Francis’ treatment. “All of that makes him a little bit more vulnerable potentially, but we just have to wait and see.”

He said that after doctors have identified clinically what is wrong, they can start treating the underlying infection with the correct therapies.

Pope’s frail health

The Argentine pope is a known workaholic who keeps up a grueling pace despite his increasingly precarious health.

In addition to his frequent bouts of respiratory infections in winter, he uses a wheelchair, walker or cane because of bad knees and suffers from sciatica nerve pain. In 2021 he had 33 centimeters (13 inches) of his colon removed because of a narrowing, and then had a further surgery in 2023 to remove intestinal scar tissue and repair an abdominal hernia.

When he had a bad case of pneumonia in 2023, he left the hospital after three days and only acknowledged after the fact that he had been admitted urgently after feeling faint and having a sharp pain in his chest. This time around, Francis insisted on finishing his morning audiences Friday before leaving the Vatican, even though he was having trouble speaking at length because he was so short of breath.

Some appearances have been scrapped

Francis’ continued hospitalization has already forced the cancellation of some events connected to the Vatican’s Holy Year and put others in question. The official Vatican calendar online has no more papal appointments or activities for February, and picks up only on March 5, Ash Wednesday. This week’s weekly general audience was canceled.

Outside the Gemelli hospital, people were praying for the pope, including Nigerian nuns in front of a giant statue of St. John Paul II. He had so many hospitalizations at Gemelli that the main entry way is decorated with a permanent photo exhibition of his ailments over the course of his quarter-century pontificate.

Sister Mary Beatrice Nnenji said prayers were necessary “because no one is strong enough on their own.”

“With age also you feel your health and especially with his workload and all the efforts he makes,” she said. “So if God wants he will go on. Let’s hope in God, we cannot go against it, whatever comes.”

NEW YORK (AP) — Paul Simon and Sabrina Carpenter duetted on Simon’s “Homeward Bound” to open the show, five-decade “Saturday Night Live” luminary Steve Martin delivered the monologue, and Paul McCartney gave an epic closing to a 50th anniversary special celebrating the sketch institution that was overflowing with famous former cast members, superstar hosts and legendary guests.

The 83-year-old Simon has been essential to “SNL” since its earliest episodes in 1975, and told the 25-year-old pop sensation of the moment Carpenter that he first performed “Homeward Bound” on “SNL” in 1976.

“I was not born then,” Carpenter said, getting a laugh. “And neither were my parents,” she added, getting a bigger laugh.

McCartney closed with the rarely performed song cycle from the Beatles’ “Abbey Road,” “Golden Slumbers/Carry That Weight/The End,” with its wistful ending, “the love you take, is equal to the love you make.”

Lil Wayne and Miley Cyrus were among the night’s other musical guests, though the show’s musical legacy also had its own night with a Radio City Music Hall concert on Friday.

“SNL50: The Anniversary Celebration” aired live from New York, of course, on NBC and Peacock. The pop culture juggernaut has launched the careers of generations of comedians including Eddie Murphy, Kristen Wiig and Will Ferrell, who all appeared in early sketches.

And the evening included epic cameos that included Meryl Streep, Jack Nicholson and Keith Richards.

Steve Martin’s opening sets tone for ‘SNL50,’ ‘Update’ keeps it rolling

Martin, one of the shows most prolific hosts and guests since the first season in 1975, tried to keep it current in the monologue even on a backward-looking night.

Martin said when the show’s creator Lorne Michaels only told him he’d be doing the monologue, “I was actually vacationing on a friend’s boat down on the Gulf of Steve Martin.”

He was joined by former “SNL” luminaries and frequent hosts Martin Short and John Mulaney, who looked at the star-studded crowd full of former hosts in the same Studio 8H at 30 Rockefeller Plaza that has been the show’s longtime home.

“I see some of the most difficult people I have ever met in my entire life,” Mulaney said. “Over the course of 50 years, 894 people have hosted ‘Saturday Night Live,’ and it amazes me that only two of them have committed murder.”

Later, on the night’s “Weekend Update,” anchor Colin Jost said there are so many former hosts and musical guests that wanted to see the show that many had to be seated in a neighboring studio and some had to watch “from the Metropolitan Detention Center in Brooklyn” as a photo of Sean “Diddy” Combs appeared.

Martin took a jab at the always-difficult-to-wrangle Bill Murray in his monologue.

“We wanted to make sure that Bill would be here tonight,” Martin said, “so we didn’t invite him.”

Murray appeared on “Weekend Update” to rank the show’s anchors since they began with Chevy Chase. He poked at the whiteness of the group by first ranking its Black anchors, a list of just one, current co-anchor Michael Che.

The extravaganza came after months of celebrations of “Saturday Night Live,” which premiered Oct. 11, 1975, with an original cast that included John Belushi, Chase and Gilda Radner.

It’s become appointment television over the years as the show has skewered presidents, politics and pop culture.

“It is a honor and a thrill to be hosting weekend update for the 50th and if it was up to our president final season of SNL,” Jost said.

The show had its typical ending, with all involved looking exhilarated and exhausted on the studio stage. This night it was so crowded with luminaries it looked like it might break. Led by Short, they all applauded in tribute to Michaels, who created the show and has run it for 45 of its 50 years.

Cameos and memorials

Alec Baldwin, the show’s most frequent host with 17 stints, appeared to introduce an evening of commercial parodies, seven months after his trial was halted and an involuntary manslaughter charge was dropped in the shooting of cinematographer Halyna Hutchins.

Aubrey Plaza made one of her first public appearances since the January death of her husband when she introduced Cyrus and Howard’s performance.

The 87-year-old Nicholson was once a constant in the front rows of the Oscars and Los Angeles Laker games, but is rarely seen out anymore. He introduced his “Anger Management” co-star Adam Sandler, who sang in his signature style about the show’s history. He gave a roll-call of cast members, giving special attention to several who have died, including his friends Chris Farley and MacDonald along with Radner, Jan Hooks and Phil Hartman.

It ended with, “six years of our boy Farley, five of our buddy Norm.”

The show didn’t have a formal “in memoriam” section, though it pretended to when 10-time host Tom Hanks came out somberly to mourn “SNL characters and sketches that have aged horribly.”

A montage began with the late Belushi’s “Samurai” character. The word “Yikes” appeared on screen in a sketch that included Mike Myers and a young Macaulay Culkin in a bathtub. A “body shaming” label appeared over the beloved sketch of Farley and the late Patrick Swayze as Chippendale’s dancers, and “slut shaming” appeared over one of the show’s earliest, catchphrases, Dan Aykroyd saying “Jane, you ignorant slut” to Jane Curtin. The current-day Aykroyd was a notable absence.

The oldest former cast member, 88-year-old Garrett Morris, appeared to introduce a film that showed the whole original cast.

“I had no idea y’all that I would be required to do so many reunion shows,” he said.

Sketches and bits jam-packed with former cast and hosts

The first sketch featured a mash-up of former cast members and hosts. Fred Armisen hosted a “Lawrence Welk Show” that featured Ferrell as Robert Goulet.

Former hosts Kim Kardashian and Scarlett Johansson — Jost’s wife — gave an updated version of the elegant singing Maharelle Sisters with former cast members Ana Gasteyer and Wiig, who provided the traditional punchline “And I’m Dooneese” with a balding head and creepy, tiny doll arms.

It was followed by “Black Jeopardy,” hosted by the show’s longest running (and still current) cast member, Kenan Thompson, who called the game show the only one “where every single viewer fully understood Kendrick’s halftime performance.”

It showcased many of the show’s most prominent Black cast members through the years including Tracy Morgan and Murphy, doing a Morgan impression.

“Big Dog gonna make some big money!” Murphy-as-Morgan shouted.

Streep walked on as the mother of McKinnon’s constant alien abductee Miss Rafferty, with the same spread legs and vulgar manner.

Streep’s fellow all-time-great actor Robert De Niro paired with Rachel Dratch in a “Debbie Downer” sketch with its traditional trombone accompaniment.

Former cast member Amy Poehler and former lead writer Tina Fey, who partnered as “Weekend Update” anchors, led a Q-and-A with audience questions.

Ryan Reynolds stood, and they asked him how it’s going.

“Great, why?” he said defensively. “What have you heard?”

Reynolds and wife Blake Lively, sitting next to him, have been locked in a heated legal and media battle with her “It Ends With Us” director and co-star Justin Baldoni.

Julia Louis-Dreyfus, Adam Driver, Cher, Bad Bunny, Peyton Manning and Richards were also featured in the bit.

Poehler also paired with Rudolph for a revival of their mock talk show “Bronx Beat,” that featured Mike Myers as his mother-in-law-inspired, Streisand-loving character “Linda Richman.”

“Look at you, both of you, you look like buttah,” Myers said.