Pope Francis has the onset of double pneumonia, the Vatican said on Tuesday, complicating treatment for the 88-year pontiff and indicating a further deterioration in his fragile health.

The Vatican said that the pontiff had pneumonia in both lungs and that he “continued to present a complex picture.”

Pope Francis, 88, was hospitalized last Friday with bronchitis, the Vatican said, and now has a “polymicrobial infection of the respiratory tract.”