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ROME (AP) 鈥� Pope Francis had coffee and was reading newspapers Saturday after an alarming setback in his two-week recovery from double pneumonia: Doctors had to put him on noninvasive mechanical ventilation following a coughing fit in which he inhaled vomit that needed to then be extracted.

Doctors said it would take a day or two to evaluate how and if the Friday afternoon episode impacted Francis鈥� overall clinical condition. His prognosis remained guarded, meaning he wasn鈥檛 out of danger.

In its morning update Saturday, the Vatican said the 88-year-old pope didn’t have any further respiratory crises overnight: 鈥淭he night has passed quietly, the pope is resting.” He had coffee in the morning for breakfast, suggesting that he was not dependent on a ventilation mask to breathe and was still eating on his own.

In the late Friday update, the Vatican said Francis suffered an 鈥渋solated crisis of bronchial spasm,鈥� a coughing fit in which Francis inhaled vomit, that resulted in a 鈥渟udden worsening of the respiratory picture.鈥� Doctors aspirated the vomit and placed Francis on noninvasive mechanical ventilation.

The pope remained conscious and alert at all times and cooperated with the maneuvers to help him recover. He responded well, with a good level of oxygen exchange and was continuing to wear a mask to receive supplemental oxygen, the Vatican said.

The episode, which occurred in the early afternoon, marked a setback in what had been two successive days of increasingly upbeat reports from doctors treating Francis at Rome鈥檚 Gemelli hospital since Feb. 14. The pope, who had part of one lung removed as a young man, has lung disease and was admitted after a bout of bronchitis worsened and turned into pneumonia in both lungs.

Doctors say the episode is alarming

The Vatican said the episode was different from the prolonged respiratory crisis on Feb. 22, that was said to have caused Francis discomfort.

Dr. John Coleman, a pulmonary critical care doctor at Northwestern Medicine in Chicago, said the isolated episode Friday as relayed by the Vatican was nevertheless alarming and underscored Francis鈥� fragility and that his condition 鈥渃an turn very quickly.鈥�

鈥淚 think this is extremely concerning, given the fact that the pope has been in the hospital now for over two weeks, and now he鈥檚 continuing to have these respiratory events and now had this aspiration event that is requiring even higher levels of support,鈥� he told The Associated Press.

鈥淪o given his age and his fragile state and his previous lung resection, this is very concerning,鈥� added Coleman, who is not involved in Francis鈥� care.

Dr. William Feldman, a pulmonary specialist at Brigham and Women鈥檚 Hospital in Boston, said it was a good sign that the pope remained alert and oriented during the episode, but concurred that it marked 鈥渁 worrying turn.鈥�

鈥淥ften we will use noninvasive ventilation as a way of trying to stave off an intubation, or the use of invasive mechanical ventilation,鈥� Feldman said.

Types of noninvasive ventilation include a BiPAP machine, which helps people breathe by pushing air into their lungs. Doctors will often try such a machine for a while to see if the patient鈥檚 blood gas levels improve so they can eventually go back to using oxygen alone. Friday’s statement said Francis showed a 鈥済ood response鈥� to the gas exchange using the ventilation.

Doctors did not resume referring to Francis being in 鈥渃ritical condition,鈥� which has been absent from their statements for three days now. But they say he isn鈥檛 out of danger, given the complexity of his case.

Prayers continued to pour in

Francis’ hospitalization has come as the Vatican is marking its Holy Year that is drawing pilgrims to Rome from all over. They are walking through the Holy Door at St. Peter’s Basilica and also making pilgrimages to the hilltop Umbrian town of Assisi, to pray at the home of Francis’ namesake, St. Francis.

鈥淓very day we鈥檙e praying for the pope,” said the Rev. Jacinto Bento, a priest visiting Assisi on Saturday with a group of 30 Jubilee pilgrims from the Azores Islands. 鈥淲e鈥檙e very sad for his situation.鈥�

Veronica Abraham, a catechist and Argentine native, came to Assisi on Saturday with her two children and other kids from her parish on Lake Garda and said the group had prayed for the pope at every church they’d visited.

鈥淚鈥檓 sure that he鈥檚 hearing our prayers, that he feels our closeness,鈥� she said.

Serena Barbon, visiting Assisi from Treviso on Saturday with her husband and three children, said she hoped that if Francis doesn’t make it, the next pope will be just like him.

鈥淗e鈥檚 been very charismatic and we pray for him and that any new pope might also be someone who puts the poor in the center. Because we鈥檙e all a bit the poor,鈥� she said.

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Dell’Orto reported from Assisi, Italy. Associated Press writer Carla K. Johnson in Washington state contributed to this report.

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Associated Press religion coverage receives support through the AP鈥檚 with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.