EWTN News explains: Who’s in charge of the Vatican while Pope Leo XIV is hospitalized?

Pope Leo XIV entered the hospital on Oct. 13 to undergo surgery to remove a lung nodule. The Vatican has said his recovery in the hospital will take at least a week and the pope’s appointments are canceled through Oct. 20.

An extended hospital stay for one of the most important leaders in the world may raise the question: Who exactly runs the Vatican wh

en a pope is hospitalized or unable to perform his normal duties?

Matthew Bunson, vice president and editorial director of EWTN News and the author of numerous books on Catholicism including “Encyclopedia of Catholic History,” told EWTN News in 2025 after then-Pope Francis was hospitalized that in such cases, “the machinery of state tends to keep functioning.”

Andreas Widmer, an associate professor of practice in entrepreneurship at The Catholic University of America’s Busch School of Business and former Swiss Guard at the Vatican, likewise said much of the Vatican’s administration continues even when the pope is sick.

“Things keep going. He is kept apprised by [Vatican officials],” said Widmer, who served as a Swiss Guard under Pope John Paul II in the 1980s and who regularly returns to the Vatican to work with the…