ROME — Pope Francis met privately with King Charles III and Queen Camilla on Wednesday at the Vatican during the royal couple’s four-day state visit to Italy and on the occasion of their 20th wedding anniversary, the Vatican announced.

It was the first known meeting since the pope’s return to the Vatican after five weeks in the hospital for life-threatening double pneumonia. Francis had planned to have an audience with Charles, but the official state visit to the Vatican was postponed due to the pope’s health.

The pope issued a new invitation for a private audience, but it was subject to his health and only confirmed Wednesday morning. The mid-afternoon visit lasted about 20 minutes and included a private exchange of gifts. Discussions continue about a future visit by the monarch to the Vatican.

The Vatican statement said the pope wished Charles and Camilla a happy anniversary, and the king and queen in return wished the pope a speedy recovery. Buckingham Palace said “their majesties were delighted the pope was well enough to host them, and to have had the opportunity to share their best wishes in person.”

In a photo released by the Vatican on Thursday, Camilla is seen shaking the pope’s hand as a smiling Charles holds a red gift box. The pope, seated as he greets the royal couple, is not wearing nasal tubes. The Vatican has said that his reliance on supplemental oxygen is decreasing, and that he can spend short periods of time without the tubes.

The royal couple previously saw Francis during an April 2017 visit to the Vatican. King Charles, then Prince of Wales, also met Pope Francis during the 2019 canonization of St. John Henry Newman.

The pope has been convalescing at the Vatican since March 23 and made an appearance to the faithful in St. Peter’s Square on Sunday. He was pushed in a wheelchair, wearing nasal tubes for supplemental oxygen, and wished the crowd a good Sunday from the front of the altar before being greeted by participants in the Mass, some of whom leaned to kiss his hands.