Pope Francis overcame concerns about his health to preside over Easter Sunday Mass, leading tens of thousands of people in a flower-decked St Peter’s Square in one of the most important events of the year.

Just hours after celebrating the two-and-a-half-hour night-time Easter Vigil, the 87-year-old pontiff appeared in good form at the start of the liturgy in the blustery piazza on Sunday.

Francis, who had part of one lung removed as a young man, has been battling respiratory problems all winter that the Vatican and he have said were bronchitis, the flu or a cold.

Easter Mass is one of the most important dates on the liturgical calendar, celebrating what the faithful believe was Jesus’s resurrection after his crucifixion.

The Mass precedes the Pope’s “Urbi et Orbi” – to the city and the world – blessing, a lengthy speech that traditionally rounds up all the threats facing humanity.

For the past few weeks, Francis has generally avoided delivering long speeches to avoid the strain on his breathing. He ditched his Palm Sunday homily last week and decided at the last minute to miss the Good Friday procession at the Colosseum.

Pope Francis
Pope Francis presided over the Easter Vigil on Saturday evening (Alessandra Tarantino/AP)

The Vatican said in a brief explanation that the decision was made to “conserve his health”.

The decision appeared to have paid off, as Francis was able to recite the prayers of the lengthy Saturday night Easter Vigil service, including administering the sacraments of baptism and First Communion to eight new Catholics, and preside over Easter Sunday Mass.

After a busy Holy Week, Francis should have some time to recover as there are no major foreign trips scheduled for several months.