Thousands of people gathered in St Peter’s Square on Monday evening to pray for an ailing Pope Francis.

Those gathered expressed sorrow for his suffering, hope for his recovery and gratitude for his efforts to steer the Catholic Church in new directions.

The 88-year-old Francis has pneumonia in both lungs and remains in critical condition despite showing a slight improvement after 11 days in the hospital.

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As Cardinal Pietro Parolin, the Vatican’s No 2, led prayers for 45 minutes on a chilly, rainy night, the faithful fingered rosary beads while hoping for Francis’ recovery.

The Vatican issued a dose of optimism earlier in the evening, delivering a more upbeat health bulletin than in recent days.

Still, the mood was mostly grim in the monumental square, with many of the roughly 4,000 assembled understanding they may be in Rome for Francis’ final days.

Crowds sat under umbrellas on folding chairs or stood by the vast colonnades as they reflected fondly on the pontiff’s legacy.

An image of Pope Francis is seen among candles in front of the Agostino Gemelli Polyclinic, in Rome (AP/Andrew Medichini)

Roberto Allison, a priest from the Mexican state of Guadalajara, said members of his community had come together to show appreciation for “all that we have learned from him”.

Stopping to deliver personal blessings to some at the end of the ceremony, Cardinal Angelo Bagnasco said the crowd’s diversity — many world languages could be heard spoken — was “a big sign of comfort” for the Catholic Church.

The Argentine pope, who had part of one lung removed as a young man, has been at Rome’s Gemelli hospital since February 14 and doctors have said his condition is touch-and-go, given his age, fragility and pre-existing lung disease.

But in Monday’s update, they said he had not had any more respiratory crises since Saturday, and the supplemental oxygen he is using continued but with a slightly reduced oxygen flow and concentrations.

A couple of Catholic tourists from Chicago, who arrived holding umbrellas well before the service started, said they prayed for the pope at daily Mass earlier at St Peter’s Basilica and decided to come back.

Faithful gather to pray the rosary for the health of Pope Francis (AP/Bernat Armangue)

Like many, they found it “hard to process” they may be in Rome for Francis’ final days.

“No one knows the day and time, but it’s a historic moment nonetheless,” said Edward Burjek.

It felt the same for Hatzumi Villanueva of Peru.

She was particularly fond of former pope St John Paul II but said that Francis, as the first Latin American pope, “draws a bit closer”.

“We came to pray for the pope, that he may recover soon, for the great mission he’s sharing with his message of peace,” said Ms Villanueva, who praised his empathy for migrants.

Francis’ papacy has also emphasised the defence of the environment and partial openness to LGBTQ+ rights.

Outside of the Vatican, Romans, pilgrims and even non-Catholics said they were offering special prayers for the pope.

“We are all sorry,” said Raniero Mancinelli, who has tailored ceremonial clothing for Francis and the two previous popes in his shop just outside the Vatican’s walls.