VATICAN CITY (AP) – Pope John Paul II’s doctors were on guard for complications Wednesday, a day after the frail, 84-year-old pontiff was hospitalized with the flu and breathing trouble.

Pneumonia remained a potentially deadly threat, but the Holy See insisted there was “no cause for alarm.” Roman Catholics from Poland to the Philippines prayed for his recovery.

The pope will be hospitalized for a few more days to afford “many means to stay ready for any complications,” said Cardinal Javier Lozano Barragan, head of the Vatican’s health care office.

The slumping pontiff also suffers from Parkinson’s disease and crippling hip and knee ailments, and his inability to hold his back up straight has left his lungs and diaphragm in a crushed position, Barragan told Associated Press Television News.

Tests showed the pope’s heart and respiration were normal, and he felt well enough to participate from his bed in a Mass celebrated by his secretary, said papal spokesman Joaquin Navarro-Valls.

He said John Paul was running a slight fever and would spend “a few more days” for treatment of respiratory problems at Rome’s Gemelli Polyclinic, where he was taken by ambulance Tuesday night.

“There is no cause for alarm,” Navarro-Valls said.

Cardinal Angelo Sodano, the Vatican secretary of state, also played down the severity of the illness Wednesday evening. The pope was “recovering well,” Sodano told private Italian TV Canale 5, adding that he expected the situation to improve in a few days.

Still, American experts said a case like the pontiff’s could lead to life-threatening pneumonia. “That’s the complication of influenza that most frequently, by far, carries people off,” said Dr. William Schaffner, an infectious diseases expert at Vanderbilt University.

“I’m sure every physician (following news reports of the pope’s case) is already worried that pneumonia might develop,” Schaffner said.

Elderly men with long-standing, debilitating chronic disease like Parkinson’s often die of pneumonia, which comes as “the final straw” in a long assault by disease on the body, said geriatrics specialist Dr. William Hall of the University of Rochester.

The pope’s slumped posture would not only impede his breathing but also make it harder for him to cough normally, a reaction that in healthy people helps keep pneumonia bacteria from entering the lungs, Hall said.

Pneumonia is “often very difficult to treat because you have introduced bacteria that don’t belong in the lungs,” said Dr. Michael Freedman, head of geriatrics at New York University Medical Center.

“You usually need multiple antibiotics programs,” he said. “The big danger is that if you are having trouble getting air into you, you can just tire out and you just can’t keep up with it.”

In St. Peter’s Square, in John Paul’s native Poland and in many of the 129 countries the pope has visited over a 26-year papacy, the faithful paused to pray for the spiritual leader of the world’s 1 billion Catholics.

White House press secretary Scott McClellan said Americans’ “thoughts and prayers are with the Holy Father,” and in Rome, chief rabbi Riccarco Di Segni offered prayers for a quick recovery.

Maria Pasnik, 46, a housewife in the pope’s hometown of Wadowice, Poland, expressed a simple, anguished wish: “I pray that we can see or hear him again.”

In Mexico City, the Basilica of Guadalupe remained open during the night for anyone who wished to offer prayers. It was here, in 2002, that the pope canonized Indian saint Juan Diego during a fifth visit to the country, where he remains immensely popular.

“May he recover rapidly, because we need him,” said Isabel Chavez, who attended Mass at the basilica.

Navarro-Valls insisted that John Paul did not lose consciousness or require the insertion of a tube into his windpipe to help him breathe – a procedure known as a tracheotomy – and he characterized the hospitalization as “mainly precautionary.”

At one point, trying to appear reassuring, Navarro-Valls even joked that John Paul was taken by ambulance to a special papal suite on the 10th floor of the hospital because “the subway doesn’t go that far.”

But with the pope’s advanced age and his health in steady decline for years, “this is just one of those warning signs that everybody’s got to prepare for the inevitable,” said the Rev. Thomas Reese, editor of the Jesuit magazine America.

“As Christians, death is not something we fear,” he said. “It’s a new beginning. But it’s always disturbing.”

Navarro-Valls, who has a medical degree, said the pope was suffering from flu and acute laryngeal tracheitis – inflammation of the windpipe – which created a “certain difficulty in breathing.”

In a separate statement, the Vatican said the pope also had experienced a “larynx spasm crisis.” Experts said it was possible his Parkinson’s disease, which makes muscle control difficult, made it harder for him to breathe.

The first sign of the frail pope’s illness came Sunday, when he kept clearing his throat during a 20-minute appearance at his studio window, thrown wide open on one of Rome’s coldest days in years so he could release a pair of doves symbolizing peace into St. Peter’s Square.

The flu has been sweeping through Italy since December, and the Rome region has been among the hardest-hit. The Vatican declined to say whether the pontiff had a flu shot, but a Vatican source said it was “probable” because all employees of the Holy See were offered them.

Well-wishers gathered Wednesday outside the Gemelli clinic, nicknamed “The Third Vatican” because the pope has been admitted a half dozen times before, the first time in 1981 after he was shot by a Turkish gunman on St. Peter’s Square in 1981.

Other serious medical problems requiring hospitalization included a bowel tumor described by doctors as benign and removed in 1992, intestinal problems that led to the 1996 removal of his appendix, and a 1994 broken thigh bone, fractured in a fall in his bathroom.

With the pope hospitalized, most of the Vatican’s day-to-day operations are handled by the Curia – a well-oiled bureaucracy with centuries-old roots.

“The life of the church goes on,” said veteran Vatican-watcher Thomas Reese, a Jesuit priest who edits America, a monthly on religious affairs. Poles laid red and white roses outside the hospital, and a group of about 10 Australian students played the guitar and sang songs.

Organizers of the World Youth Day in Cologne, Germany, where the pope is scheduled to appear in August, also offered their prayers for his health and stressed that his visit was still on.

“He’s the best of them all. He’s attracted hordes of tourists from all over the world,” said Rocco Buta, a horse and buggy driver who has been taking tourists around Rome for 20 years. “He’s got to get better. We need him.”

Martin P. Lombardo, of Princeton, N.J., president of a group called Jesus Cares Ministries, climbed a hill overlooking the hospital and prayed.

“I have been praying under the pope’s windows for 16 years. Of course, now I’m praying for the pope’s health,” he said. “God is not done with the pope. God has more things for him to do.”

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Associated Press Writers William J. Kole, Daniela Petroff, Marta Falconi in Rome and Malcolm Ritter in New York contributed to this story.

AP-ES-02-02-05 1737EST

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