VATICAN CITY (AP) — A frail Pope Francis returned to the Vatican on Sunday after a five-week hospitalization for life-threatening double pneumonia, and he made a surprise stop at his favorite basilica on the way home before beginning two months of prescribed rest and recovery.

The 88-year-old pope sat in the front passenger seat of his white Fiat 500L wearing nasal tubes to give him supplemental oxygen as he entered the Perugino gate of Vatican City, where his return brought relief after fears that his illness could be fatal or lead to another papal resignation.

Francis’ motorcade from Gemelli hospital overshot the Vatican initially and took a detour across town to stop at St. Mary Major basilica, where the pope’s favorite icon of the Madonna is located and where he always goes to pray after a foreign visit.

He didn’t get out of the car but gave a bouquet of flowers to the basilica’s cardinal to place in front of the Salus populi Romani icon. The Byzantine-style painting on wood is revered by Romans and is so important to Francis that he has chosen to be buried in the basilica to be near it.

The tour through Rome’s historic center came after Francis made his first appearance in five weeks to give a thumbs-up and brief blessing from a hospital balcony. Hundreds of people had gathered on a brilliant spring Sunday morning to say goodbye and catch a first glimpse of Francis, who seemed to be gasping for air.

“I see this woman with the yellow flowers. Brava!” a bloated-looking Francis said in a breathless voice. He gave a weak sign of the cross before being wheeled back inside.

Chants of “Viva il papa!” and “Papa Francesco” erupted from the crowd, which included patients who had been wheeled outside just to catch his brief appearance.

Doctors say Francis needs two months of rest and convalescence at the Vatican, during which he should refrain from meeting with big groups of people or exerting himself. But they said he should be able to resume all his normal activities eventually.

His return home, after the longest hospitalization of his 12-year papacy and the second-longest in recent papal history, brought tangible relief to the Vatican and Catholic faithful who have been anxiously following 38 days of medical ups and downs and wondering if Francis would make it.

“Today I feel a great joy,” said Dr. Rossella Russomando, who was at Gemelli on Sunday but did not treat Francis. “It is the demonstration that all our prayers, all the rosary prayers from all over the world, brought this grace.”

The Rev. Enzo Fortunato, who heads a papal committee dedicated to children, said it was clear that Francis was happy to return home and would surely improve, especially after receiving so many get-well cards from children from around the world.

“If the first medicine was the affection of the children, the second medicine is definitely (going) home,” Fortunato said. “It will certainly speed up his recovery.”

At the Vatican, where a Holy Year is under way, pilgrims cheered and applauded when Francis’ greeting from Gemelli was broadcast live on giant TV screens in St. Peter’s Square.

“For me it was an important emotional experience to see him, because many people were waiting for this moment,” said Sister Luisa Jimènez, a nun from Francis’ native Argentina.

Another nun from the same order, Colombian Sister Angel Bernal Amparo, expressed concern, given his bloating and inability to speak much.

“He didn’t look well,” she said. “He couldn’t (talk) and I realized it was because of his breathing and, well, he left right there. But I was glad to have seen him.”

No special arrangements have been made at the Domus Santa Marta, the Vatican hotel where Francis lives in a two-room suite on the second floor next to the basilica. He will have supplemental oxygen and 24-hour medical care as needed, although his personal physician, Dr. Luigi Carbone, said he hoped Francis would progressively need less and less assistance breathing as his lungs recover.

The Argentine pope, who has chronic lung disease and had part of one lung removed as a young man, was admitted to Gemelli on Feb. 14 after a bout of bronchitis worsened.

Doctors first diagnosed a complex bacterial, viral and fungal respiratory tract infection and soon thereafter, pneumonia in both lungs. Blood tests showed signs of anemia, low blood platelets and the onset of kidney failure, all of which later resolved after two blood transfusions.

The most serious setbacks began Feb. 28, when Francis experienced an acute coughing fit and inhaled vomit, requiring the use of a noninvasive mechanical ventilation mask to help him breathe. He suffered two more respiratory crises a few days later, which required doctors to manually aspirate “copious” amounts of mucus from his lungs, at which point he began sleeping with the ventilation mask at night to help his lungs clear the accumulation of fluids.

He was never intubated and at no point lost consciousness. Doctors reported he always remained alert and cooperative, although they say he has probably lost a bit of weight given a natural loss of appetite.

“Unfortunately yes, there was a moment when many were saying that he might not make it. And it was painful for us,” said Mario Balsamo, the owner of coffee shop in front of Gemelli. “Instead, today with the discharge, we are very happy that he is well and we hope he will recover soon and will recover his strength.”

Dr. Sergio Alfieri, the medical and surgical chief at Gemelli who coordinated Francis’ medical team, stressed that not all patients who develop such a severe cases of double pneumonia survive, much less are released from the hospital. He said Francis’ life was at risk twice, during the two acute respiratory crises, and that the pope at the time understandably lost his typical good sense of humor.

“But one morning we went to listen to his lungs and we asked him how he was doing. When he replied, ‘I’m still alive,’ we knew he was OK and had gotten his good humor back,” he told a news conference late Saturday.

Alfieri confirmed that Francis was still having trouble speaking due to the damage to his lungs and respiratory muscles. But he said such problems were normal, especially in older patients, and predicted his voice would eventually return. Francis is also continuing to take medication to treat a more minor respiratory infection.

Vatican spokesman Matteo Bruni declined to confirm any upcoming events, including a scheduled audience on April 8 with King Charles III or Francis’ participation in Easter services at the end of the month. But Carbone said he hoped Francis might be well enough to travel to Turkey at the end of May to participate in an important ecumenical anniversary.

Only St. John Paul II recorded a longer hospitalization in 1981, when he spent 55 days at Gemelli for minor surgery and treatment of an infection.

Associated Press writers Silvia Stellacci and Giada Zampano in Rome and Colleen Barry in Soave, Italy, contributed.

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

ROME (AP) — The Vatican on Sunday released the first photograph of Pope Francis in more than a month, showing the pontiff in a three-quarter view from behind wearing a purple stole typical of Lenten liturgical vestments and sitting in a wheelchair before the altar of his personal hospital chapel.

The Vatican said he was participating in the celebration of the Mass with other priests in the 10th-floor papal apartment in the Gemelli hospital. No one else is visible in the photo and it is the first mention the Vatican has made of the pope’s participation in celebrating Mass since his Feb. 14 hospitalization for a bout with chronic bronchitis that quickly turned into double pneumonia.

There was no obvious sign that he was receiving supplemental oxygen mentioned in medical bulletins.

Doctors this week said the pontiff was no longer in critical, life-threatening condition, but they have continued to emphasize that his condition remained complex due to his age, lack of mobility and the loss of part of a lung as a young man. In an audio recording released March 6, the pope spoke in a feeble and labored voice as he thanked the faithful in St. Peter’s Square for their prayers.

His condition has been gradually improving over the last week, leading the Vatican to suspend morning updates and to issue less frequent medical bulletins. An X-ray this week confirmed that the infection was clearing.

In the most recent bulletin on Saturday, doctors said they were working to reduce the pope’s reliance on a non-invasive ventilation mask at night, which will allow his lungs to work more. He was continuing to receive high-flow supplemental oxygen, delivered by a nasal tube, during the day — although no such apparatus was evident in the photograph.

Earlier Sunday, dozens of children — many from war-torn countries, and toting yellow and white balloons — gathered outside Rome’s Gemelli hospital to greet Francis on his fifth Sunday hospitalized. While the pope did not appear from the 10th-floor suite of windows, he thanked them and acknowledged their presence in the traditional Sunday blessing.

“I know that many children are praying for me; some of them came here today to Gemelli as a sign of closeness,’’ the pontiff said in the Angelus text prepared for the traditional prayer but not delivered live again. “Thank you, dearest children! The pope loves you and is always waiting to meet you,’’ Francis said.

The Rev. Enzo Fortunato, president of the pontifical committee for World Children’s Day who organized the event, said that the gathering of children with their parents was a form of spiritual medicine for the 88-year-old pontiff. He called it “the most beautiful caress.’’

“The children represent a symbolic medicine for Pope Francis,’’ Fortunato said. “Letting him know that so many children are here for him cheers the heart.’’

A small group of children, whose balloons represented the colors of the Vatican flag, briefly entered the hospital to leave behind their drawings, messages and flowers for Francis. Many of the children came from poorer Italian districts or from countries impacted by war, some having arrived in Italy from Afghanistan and Syria via humanitarian corridors set up by the Sant’Egidio charity in agreement with the Italian government; others were from Ukraine, Gaza, South America and Africa.

One of them was 12-year-old Anastasia, who got up at 5 a.m. to make the trip from Naples with the hopes of delivering the message directly to the pope. “I wrote, ‘Pope Francis, get well and return home soon,’” she said. “We love you, all of the children are praying for you.’’

Andrea Iacomini, the spokesman for UNICEF in Italy, said besides demonstrating affection for the pope, the group also wanted to say “enough″ to conflicts that are impacting 500 million children in 59 countries.

“This pope is not just a religious leader, he is a great global leader. A man of peace. This pope is pope of the children.″ Iacomini said.

Francis typically delivers the Angelus from a window overlooking St. Peter’s Square to the gathered faithful, who have grown more numerous due to the Jubilee year that Francis inaugurated in December.

In the written text, Francis said he was thinking of others, who like him, are in a fragile state. “Our bodies are weak, but even like this, nothing can prevent us from loving, praying, giving ourselves, being for each other, in faith, shining signs of hope,’’ the pope said.

Along with a stop at St. Peter’s to seek indulgences by walking through the basilica’s Holy Door, pilgrims are now also adding a stop at Gemelli, a 15-minute train ride from the Vatican.

Francis has not been seen publicly since he was admitted to the hospital after a bout of bronchitis that made it difficult for him to speak. Doctors soon added a diagnosis of double pneumonia and a polymicrobial (bacterial, viral and fungal) infection.

The first three weeks of his hospitalization were marked by a rollercoaster of setbacks, including respiratory crises, mild kidney failure and a severe coughing fit. Over the the last week, his condition has stablized.

The next medical update won’t be issued until mid-week, the Vatican said.

Associated Press video journalist Francesca Primavilla contributed to this report.

ROME (AP) — A stable Pope Francis had a visit Sunday from the Vatican secretary of state as he continued his recovery from double pneumonia, the Vatican said, but again skipped his weekly noon blessing to avoid even a brief public appearance from the hospital.

Instead, the Vatican distributed a message from the pope in which he thanked his doctors for their care and well-wishers for their prayers, and prayed again for peace in Ukraine and elsewhere.

“From here, war appears even more absurd,” Francis said in the message, which he drafted in recent days from the Gemelli hospital, the Vatican said. Francis said he was living his hospitalization as an experience of profound solidarity with people who are sick and suffering everywhere,

“I feel in my heart the ‘blessing’ that is hidden within frailty, because it is precisely in these moments that we learn even more to trust in the Lord,” Francis said in the text. “At the same time, I thank God for giving me the opportunity to share in body and spirit the condition of so many sick and suffering people.”

It marked the third weekend in a row that Francis has canceled the Sunday appointment delivering the Angelus prayer in person. He could have done so from his 10th floor hospital suite at the Gemelli hospital if he were well enough.

But many signs indicated he was recovering and improving. “The night was quiet, the pope is still resting,” the Vatican said in its Sunday update.

Cardinal Pietro Parolin and his chief of staff, Archbishop Edgar Pena Parra, called on the pope Sunday morning, their second visit since Francis’ Feb. 14 hospitalization, according to the Vatican spokesman, Matteo Bruni. There were no details of what was discussed, but the mere visit suggested Francis’ condition was stabilizing.

“The night was quiet, the pope is still resting,” the Vatican said in its Sunday early update.

He had no fever or signs of elevated white blood cells, which would signal his body was still fighting an infection.

Doctors on Saturday reported that Francis was in stable condition, with no mention of him being critical. Their upbeat assessment came a day after a respiratory crisis that resulted in him being put on noninvasive mechanical ventilation.

But the 88-year-old pope had a “good response” in his gas exchange levels even during the “long periods” he was off the ventilator mask Saturday and only using high-flow supplemental oxygen, the Vatican said.

The fact that Francis was able to use just high-flow oxygen for long periods, without any significant effect on the levels of oxygen in his blood, was a sign his respiratory function was improving.

Doctors were cautious however and kept his prognosis as guarded, meaning he wasn’t out of danger. He was eating and drinking and continued his respiratory physiotherapy, and spent 20 minutes in his private chapel down the hall on Saturday, the Vatican said.

The pope, who had part of one lung removed as a young man, has lung disease and was admitted to Gemelli on Feb. 14 after a bout of bronchitis worsened and turned into a complex pneumonia in both lungs.

Francis’ hospitalization has come as the Vatican is marking its Holy Year, drawing pilgrims to Rome from all over. They are walking through the Holy Door at St. Peter’s Basilica and also making pilgrimages to the hilltop Umbrian town of Assisi, to pray at the home of Francis’ namesake, St. Francis.

“Every day we’re praying for the pope,” said the Rev. Jacinto Bento, a priest visiting Assisi on Saturday with a group of 30 Jubilee pilgrims from the Azores Islands. “We’re very sad for his situation.”

In an odd coincidence, Francis was supposed to have presided Saturday over a Holy Year audience in the Vatican’s auditorium for the staff of the Gemelli hospital and other health care workers. They came as planned and completed the pilgrimage, while Francis continued his recovery at the hospital.

“We thought we would be able to meet him this morning in Paul VI Hall for the Jubilee Catechesis, but he surprised us by coming to us,” said Monsignor Claudio Giuliodori, spiritual guide of the Catholic University of the Sacred Heart, of which Gemelli is a part.

Giovanni Frisullo, a Gemelli neurologist, said the atmosphere at Gemelli was one of tension and prayer. “There is a situation of waiting but also of hope,” he said.

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

ROME (AP) — Pope Francis remained in stable condition Saturday a day after a respiratory crisis during his battle with double pneumonia, the Vatican said. He spent long periods of the day off the noninvasive mechanical ventilation he initially needed in a sign that his lung function was improving.

Francis had no further episodes of bronchial spasms like the one he suffered Friday, in which he inhaled vomit during a coughing fit. He had no fever and no signs of new infection, was feeding himself solid food and coffee for breakfast, and continued his respiratory physiotherapy, the Vatican said.

The 88-year-old pope had a “good response” in his gas exchange levels even during the “long periods” he was off the ventilator mask and only using high-flow supplemental oxygen. But his prognosis remained guarded, meaning he wasn’t out of danger.

“The Holy Father is always vigilant” and aware of what’s going on around him, the statement said, adding that he received the Eucharist and spent 20 minutes in prayer in the private chapel down the hall from his 10th floor hospital room.

The comparatively positive update came after Francis suffered a setback Friday in his two-week battle against pneumonia.

After the bronchial spasm, doctors aspirated the vomit and placed Francis on noninvasive mechanical ventilation, a mask that pumps oxygen into his lungs. Doctors said episode resulted in a “sudden worsening of the respiratory picture.”

The pope remained conscious and alert at all times and cooperated with the maneuvers to help him recover.

The fact that Francis on Saturday was able to use just high-flow oxygen for long periods, without any significant effect on the levels of oxygen in his blood, was a sign his respiratory function was improving.

The pope, who had part of one lung removed as a young man, has lung disease and was admitted to Gemelli after a bout of bronchitis worsened and turned into pneumonia in both lungs.

Doctors not involved in Francis’ care said Friday’s episode was particularly alarming given his existing lung disease and overall fragility.

Types of noninvasive ventilation include a BiPAP machine, which helps people breathe by pushing air into their lungs. Doctors will often try such a machine for a while to see if the patient’s blood gas levels improve so they can avoid the more invasive intubation ventilation and eventually go back to using supplemental oxygen alone.

Doctors did not resume referring to Francis being in “critical condition,” which has been absent from their statements for four days now. But they say he isn’t out of danger, given the complexity of his case.

Francis’ hospitalization has come as the Vatican is marking its Holy Year that is drawing pilgrims to Rome from all over. They are walking through the Holy Door at St. Peter’s Basilica and also making pilgrimages to the hilltop Umbrian town of Assisi, to pray at the home of Francis’ namesake, St. Francis.

“Every day we’re praying for the pope,” said the Rev. Jacinto Bento, a priest visiting Assisi on Saturday with a group of 30 Jubilee pilgrims from the Azores Islands. “We’re very sad for his situation.”

Serena Barbon, visiting Assisi from Treviso on Saturday with her husband and three children, said she hoped that if Francis doesn’t make it, the next pope will be just like him.

“He’s been very charismatic and we pray for him and that any new pope might also be someone who puts the poor in the center. Because we’re all a bit the poor,” she said.

In an odd coincidence, Francis was supposed to have presided Saturday over a Holy Year audience in the Vatican’s auditorium for the staff of the Gemelli hospital and other healthcare workers. They came as planned and completed the pilgrimage, walking through the Holy Door of St. Peter’s Basilica, while Francis continued his recovery at the hospital.

“We thought we would be able to meet him this morning in Paul VI Hall for the Jubilee Catechesis, but he surprised us by coming to us,” said Monsignor Claudio Giuliodori, spiritual guide of the Catholic University of the Sacred Heart, of which Gemelli is a part.

Giovanni Frisullo, a Gemelli neurologist, said the atmosphere at Gemelli was one of tension and prayer. “There is a situation of waiting but also of hope,” he said.

Dell’Orto reported from Assisi, Italy. Paolo Santalucia contributed from Rome. Associated Press writer Carla K. Johnson in Washington state contributed to this report.