Rome (AP): Italian Premier Giorgia Meloni visited Pope Francis for 20 minutes in the hospital on Wednesday and reported he was "alert and responsive" and full of good humour, despite his diagnosis of pneumonia and a complicated bronchial infection that has sidelined the 88-year-old pontiff for six days.

The Vatican said Francis' overall condition remained stationary but that blood tests showed a "slight improvement" in key inflammation indices. Francis also worked in the afternoon with his collaborators, the Vatican said in a late statement.

Meloni said she wanted to bring get-well wishes to the pope on behalf of the government and entire nation. "We joked around as always. He has not lost his proverbial sense of humour," she said in a statement issued by her office.

Meloni is the first confirmed outside visitor known to have called on the pope, beyond his secretaries and medical team, since his admission on Friday at Rome's Gemelli hospital, where popes have their own suite on the 10th floor.

The Vatican has said Francis was up, eating and had gotten out of bed after a tranquil night, a day after tests confirmed he had pneumonia in both lungs on top of asthmatic bronchitis.

The Italian premier, who came to power in 2022 with a message touting her Christian credentials, has referred in glowing terms to the influence on her of Popes John Paul II and Benedict XVI, both reference points for European conservatives like herself. While she and Francis don't see eye-to-eye on her crackdown on migrants, they have teamed up constructively on a campaign to reverse Italy's low birthrate.

Her visit came as prayers were pouring in for Francis' recovery.

Francis also received another get-well wish from US Vice-President JD Vance, whom the pope recently targeted in criticising the Trump administration' s plans for mass deportations of migrants.

"Let's all say a prayer for Pope Francis, who appears to have some serious health issues," Vance, a Catholic, posted on X from his private account.

Francis was admitted to the Gemelli hospital on Friday after a weeklong bout of bronchitis worsened. On Monday, medical personnel determined that he was suffering from a polymicrobial respiratory tract infection, meaning a mix of viruses, bacteria and possibly other organisms had colonised in his respiratory tract. Late on Tuesday, the Vatican said a chest CT scan showed the onset of bilateral pneumonia on top of asthmatic bronchitis, which is being treated with cortisone and antibiotics.

"I think the key will be how well and quickly he responds to treatment," said Dr Andrew Chadwick, a respiratory and intensive care specialist at Oxford University Hospitals.

Bronchitis can lead to pneumonia, which is a deeper and far more serious infection of the lungs' air sacs. Pneumonia can develop in part or all of one lung or in both lungs. It tends to be more serious when both lungs are affected because there isn't healthy tissue to compensate.

Treatment varies by severity but can include providing oxygen through a nasal tube or mask, intravenous fluids -- and treatment of the underlying cause of the infection. To date, Francis is breathing on his own and his heart function is said to be good. He has eaten breakfast every day, gotten out of bed, read the newspapers and done some work from his hospital room.

The Vatican hasn't provided any information about how Francis is responding to any of the drugs he has been given other than to say he isn't running a fever. The Argentine pope, who has previously admitted to being a non-compliant patient, has a number of conditions that make him particularly at risk for complications: Aside from his age, he is not physically active and uses a wheelchair, limiting his ability to clear the fluids building up in his lungs.

Dr Meredith McCormack, director of pulmonary and critical care medicine at Johns Hopkins University, said doctors will be looking to see if Francis responds to the therapy, which can include physiotherapy to help clear the lungs. Severe cases of pneumonia are typically treated for about one to two weeks, but recovery in an older person could extend beyond that.

"Lack of worsening would be an encouraging sign," said McCormack, who is not involved in Francis' care.

The Vatican has given no indication of how long the pope might remain hospitalised, only saying that the treatment of such a "complex clinical picture" would require an "adequate" stay.

Despite the less than positive news about Francis' condition, Francis was receiving get-well drawings and cards from children being treated in the hospital's oncology ward. And at the Vatican on Wednesday, Holy Year pilgrimages continued, with groups of faithful walking through the Holy Door of St Peter's Basilica on a chilly and cloudy day.

"We are very happy to be here but we are also sad for the pope's sickness," said Amparo Alcala', who was leading a large group of pilgrims from Valencia, Spain. "He is doing great things, most of all for the women in the church, and this gives us a lot of joy. We are praying for his recovery and that he might come back, if this is God's will."