Dr. Nelson Castro, a close friend of Pope Francis and author of “The Health of the Popes,” told VOA that the pontiff’s health has worsened and his medical team is on high alert.

The Vatican has confirmed that Pope Francis remains hospitalized in “critical condition” to treat a complex lung infection. At the same time, sources close to him confirmed to the Voice of America that “there is cause for concern” since over the weekend, the pontiff’s health had worsened “significantly.”

This was confirmed to VOA by Dr. and journalist Nelson Castro, a physician with extensive experience, close friend of the Holy Father and author of The Health of the Popes, who highlighted the complications that have raised alarm bells.

“He was given high-flow oxygen, that is, he was given oxygen through a nasal cannula” because “he suffered from anemia and platelet loss.”

The Argentine specialist admitted that this situation “generates concern” since “this is a complication associated with the infection, indicating that the infection is not yet fully under control.”

These words add to the statement of Sergio Alfieri, Francis' personal physician, who said that "the Pope is still in a delicate situation," demonstrating the seriousness of the case.

Castro, who is in constant communication with the medical team at Gemelli Hospital in Rome, Italy, where the pontiff is hospitalized, insisted that the Holy Father “is lucid and fully aware of everything that is happening to him.”

In an online interview with VOA from Buenos Aires, Argentina, he stressed that although Francis “experienced a major respiratory emergency, he was not intubated.” The problem, in his opinion, is that “the situation was prolonged and it was very difficult to reverse it.”

In addition, "the appearance of this pattern of platelet decline and anemia that had not been present until May 10" was detected, indicating a deterioration that requires extreme vigilance.

Given this uncertainty, Dr. Castro pointed out that "doctors will be following the parameters of the clinical evolution, and seeing if the evolution is good or if new complications arise."

The specialist described the protocol as “a state of armed expectation in the sense that everyone is alert to any complication that could occur in order to act” and clarified that, although “in principle everything is stabilized,” the team is not letting its guard down, aware that there could be new complications in the coming hours.

The Pope and his health

Although the doctor clarifies that his privileged position to write about the Pope's health did not give him "a condition of extreme closeness to him," he does admit to having in-depth knowledge of the Pope's medical history, which positions him as "an authoritative voice" on a matter that has generated numerous speculations.

Nelson Castro's relationship with Pope Francis goes back several decades. “I interviewed him twice when he was archbishop of Buenos Aires,” but it was not until 2017 that the Pontiff asked him to write the book The Health of the Popes .

"This is the first time in the history of the papacy that a Pope has decided to speak so clearly about his health," Castro said.

Why did Pope Francis' health deteriorate?

Castro identified four key factors that have contributed to Pope Francis' decline:

His advanced age (88 years) : any complication in a person of his age represents a high risk.

His respiratory history : Since having part of his lung removed as a youth, Francisco has had lung weakness, making him prone to respiratory infections.

His reduced mobility : "Not being able to walk has caused him serious complications," Castro explained, highlighting the impact on his circulatory and general system.

Delay in treatment : The specialist regretted that the Pope had not been hospitalized earlier, as he had already been showing worrying symptoms in the previous days and continued to carry out outdoor activities in the cold of Rome.

“An extraordinary strength”

Nelson Castro reflected on the relationship between the Pope's health and his public image. "Francis is a man of power, he feels comfortable in power, and he is fully aware of what a health problem means," said the doctor, aware that "every time a pope falls ill there is an atmosphere of conclave," referring to the rite celebrated after the death of a pontiff to elect the next one.

Even in the midst of the crisis, Castro highlighted the strength of Francis, the first Latin American to hold the post in the millennia-old history of the Catholic Church. “Another 88-year-old person with pneumonia like the Pope’s would probably not be alive, which shows that he has extraordinary strength.”

On the other hand, the doctor stresses that the Argentine pontiff has shown an unusual openness about his mental health, something rare in religious figures of his level. "He has spoken publicly about the anxiety and neurosis he faced during the Argentine dictatorship," Castro recalled, adding that he even consulted a psychiatrist at that time to manage stress.

The Pope has already spoken about death

Pope Francis has frankly addressed the possibility of his death. In his book The Health of the Popes , Nelson Castro asked him how he imagined his end. "It could be as Pope or Pope Emeritus and in Rome," the pontiff replied, making it clear that he is considering the possibility of resigning if his state of health prevents him from doing so.

For now, the medical team continues to maintain constant monitoring, evaluating the Pope's progress and preparing for any eventuality.