ROME — 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’ overall clinical condition. His prognosis remained guarded, meaning he wasn’t out of danger.

In its morning update Saturday, the Vatican said the 88-year-old pope didn’t have any further respiratory crises overnight: “The 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 “isolated crisis of bronchial spasm,” a coughing fit in which Francis inhaled vomit, that resulted in a “sudden worsening of the respiratory picture.” 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’s 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’ fragility and that his condition “can turn very quickly.”

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

“So given his age and his fragile state and his previous lung resection, this is very concerning,” added Coleman, who is not involved in Francis’ care.

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

“Often we will use noninvasive ventilation as a way of trying to stave off an intubation, or the use of invasive mechanical ventilation,” 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’s blood gas levels improve so they can eventually go back to using oxygen alone. Friday’s statement said Francis showed a “good response” to the gas exchange using the ventilation.

Doctors did not resume referring to Francis being in “critical condition,” which has been absent from their statements for three days now. But they say he isn’t 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.

“Every day we’re 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. “We’re very sad for his situation.”

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.

“I’m sure that he’s hearing our prayers, that he feels our closeness,” 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.

“He’s 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’re all a bit the poor,” 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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