Pope Francis has sent Syrian President Bashar Assad a letter expressing his "profound concern" for the humanitarian situation in Syria and in particular the plight of civilians in Idlib province.

The Vatican said Cardinal Peter Turkson, one of Francis' top advisers, hand-delivered the letter to Assad during a meeting Monday in Damascus attended by the Vatican's ambassador to Syria.

It was an unusual, hands-on gesture meant to show Francis' concern about the situation.

Assad's office said in a statement the talks focused on political efforts to end the crisis, with Syria's president blaming regional and western countries for supporting insurgents.

The Vatican's secretary of state, Cardinal Pietro Parolin, said the letter asked for civilian lives and key infrastructure to be protected, and urged Assad to take concrete steps for reconciliation.