The pontiff, 88, continues papal duties despite ill health, approving long-term church reform from his hospital room.

The Vatican has released the first picture of Pope Francis since the 88-year-old was admitted to hospital last month for double pneumonia.

The picture, published on Sunday, shows Francis from behind, facing an altar after celebrating mass in a chapel at the hospital.

The pope entered Rome’s Gemelli Hospital on February 14 with a severe respiratory infection that has required evolving treatment. He has not been seen in public since.

The pontiff, who has been receiving oxygen throughout his treatment, appears to be breathing on his own in the photo.

Journalists and the faithful have been asking for images of the pope as the last image of Francis was published more than a month ago, a Vatican News report said.

Since being hospitalised, the only other sign of the pope has been audio released on March 6 where a fatigued Francis could be heard thanking all those who have been praying for his recovery.

Concerning his health, “the situation remains stable” the report said, but still within a “complex clinical picture”.

Doctors this week said Francis was no longer in critical, life-threatening condition. But they have continued to emphasise that his condition remained complex due to his age, lack of mobility and the loss of part of a lung as a young man.

Still, the pope has continued performing his duties. On Saturday, he approved a three-year implementation and evaluation process for a reform project that aims to make the Roman Catholic Church more welcoming and responsive. The Vatican office for the Synod of Bishops released a timetable through 2028 to implement the reforms and said Francis had approved the calendar last week.