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CESENA, Italy (AP) — American motorcycle racer Nicky Hayden remains in “extremely critical” condition in hospital two days after he was hit by a car while training on his bicycle.

Hayden, who was in Italy following a race at nearby Imola, was transported to a local hospital following the incident on the Rimini coast, before being transferred to Cesena.

The Maurizio Bufalini Hospital, where Hayden is being treated, said on Friday that his condition “remains unchanged” and “is extremely critical.”

The hospital has said he has severe cerebral damage and multiple traumatic injuries.

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The 35-year-old Hayden won the MotoGP title in 2006. He is 13th in this season’s Superbike standings.

Several family members have flown in from the United States, including his mother and brother. Hayden’s father is too ill to travel.