ROME, Italy — A weak and frail Pope Francis left the hospital Sunday after surviving a five-week, life-threatening bout of pneumonia, giving a thumbs up to an adoring crowd and taking a detour to go pray at a Rome-area church before returning home to the Vatican.

A motorcade carrying the 88-year-old pope wound its way through light Rome traffic Sunday morning and kept going after reaching Vatican City, where crowds of people had lined the streets to welcome him home. Francis later arrived across town at St. Mary Major basilica, where his favorite icon of the Madonna is located and where he always goes to pray after a foreign visit.

Before leaving Gemelli hospital, Francis gave a thumbs up and acknowledged the crowd after he was wheeled out onto the balcony overlooking the main entry. Hundreds of people had gathered on a brilliant Sunday morning to say goodbye.

“I see this woman with the yellow flowers. Brava!” a tired and bloated-looking Francis said. 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, who announced his planned release at a Saturday evening news conference, said he should refrain from meeting with big groups of people or exerting himself, but that eventually he should be able to resume all his normal activities.

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, a doctor from Salerno who didn’t treat Francis but was at Gemelli on Sunday. “It is the demonstration that all our prayers, all the rosary prayers from all over the world, brought this grace.”

At the Vatican Sunday, pilgrims flocked as they have all year to St. Peter’s Basilica to participate in the 2025 Holy Year. They swarmed St. Peter’s Square and progressed through the Holy Door in groups, while big TV screens in the square were turned on to broadcast Francis’ hospital greeting live.

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

While the pneumonia infection has been successfully treated, Francis will continue to take oral medication for quite some time to treat the fungal infection in his lungs and continue his respiratory and physical physiotherapy.

“For three or four days he’s been asking when he can go home, so he’s very happy,” Carbone said.

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 on 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, though 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 case 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 said.

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 to normal.

The 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.

Francis is also returning to the Vatican in the throes of a Holy Year, the once-every-quarter-century celebration scheduled to draw more than 30 million pilgrims to Rome this year. The pope has already missed several Jubilee audiences and will presumably miss several more, but Vatican officials say his absence hasn’t significantly impacted the numbers of expected pilgrims arriving.

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.