Pope Francis died of stroke and heart failure

Vatican death certificate says pontiff fell into coma before he passed away

World leaders send condolences after Pope's death

Pope Francis died after a stroke and irreversible heart failure, Vatican doctor Andrea Arcangeli said in a death certificate released on Monday evening.

The certificate, which was published by the Vatican, said the pontiff, 88, had fallen into a coma before his death early on Monday.

Pope Francis had been considerably weakened after a severe respiratory infection kept him in hospital for five weeks. Doctors said he developed pneumonia in both lungs and suffered two episodes of "acute respiratory failure" before he was discharged on March 23.

The Pope had suffered increasingly poor health in recent years, with bouts of bronchitis and knee pain that forced him to use a wheelchair.

He had colon surgery in 2021 and a hernia operation in June 2023, months after he was admitted to hospital for three days with bronchitis.

His recent hospital stay was his longest and raised speculation that he might step down. But he brushed off talk of quitting, saying in February 2023 that papal resignations should not become "a normal thing".

In a memoir published last year, Pope Francis wrote that resignation was a "distant possibility" justified only in the event of "a serious physical impediment".

The Pope said in his memoir that he wished for a less "excessive" funeral: "With dignity, but like any Christian, because the Bishop of Rome is a pastor and a disciple, not a powerful man of this world."

He did indicate, however, that he wanted to be buried in the Papal Basilica Santa Maria Maggiore. No pope has been buried in the basilica since the 17th century.

"The Vatican is the home of my last service, not my eternal home," Pope Francis wrote.