On Ash Wednesday, observant Catholics receive a sign of the cross in ashes on their foreheads, a gesture that underscores human mortality. It is an obligatory day of fasting and abstinence for Catholics that signals the start of Christianity’s most penitent season.

Because of the continued complexity of his case, his doctors continue to hold that his "prognosis remains guarded."

While Pope Francis remained hospitalized at Rome's Gemelli Hospital, Italian Cardinal Angelo De Donatis celebrated the Ash Wednesday Mass in his place at the Basilica of Santa Sabina, March 5 in Rome.

VATICAN CITY (RNS) — Pope Francis’ condition remained stable on Wednesday (March 5), according to a Vatican statement relaying his doctors’ reports. As Francis is being treated for pneumonia in both lungs at the Gemelli Hospital in Rome, the Vatican prepares to celebrate Lenten events without the pontiff.

Catholic cardinals in Rome marked the start of the Lent religious season on Wednesday without Pope Francis, as the 88-year-old spent his 20th day in hospital seriously ill with pneumonia.

Pope Francis has increased his level of physical therapy and remains in stable condition, the Vatican said on Wednesday night.

West neighbors pray for Pope Francis on Ash Wednesday

At Ash Wednesday services there was special consideration for the leader of the church, Pope Francis, as he remains hospitalized.