Christians receive a sign of the cross in ashes on their forehead during the service – a rite intended to remind people of their mortality. Donatis dwelt on the theme in his sermon.
“In many ways, we try to banish death from our societies … Death, however, imposes itself as a reality with which we have to reckon, a sign of the precariousness and brevity of our lives,” he said, in the homily which had been originally prepared for Francis to deliver.
The Vatican said the pope had also taken part in an Ash Wednesday service in his hospital suite.
Francis has experienced several bouts of ill health over the last two years and is prone to lung infections because he had pleurisy as a young adult and had part of one lung removed.
Double pneumonia is a serious infection in both lungs that can inflame and scar them, making it difficult to breathe.