The mayor of quake-hit Ussita said a huge cloud of smoke erupted from the crumbled buildings.
« It’s a disaster, a disaster! » Mayor Marco Rinaldi told the ANSA news agency. « I was sleeping in the car and I saw hell. »
Another hard-hit city, Castelsantangelo sul Nera, also suffered new damage.
The quake was felt throughout the Italian peninsula, with reports as far north as Bolzano and as far south as Bari. Residents rushed into the streets in Rome, where ancient palazzi shook, swayed and lurched for a prolonged spell.
The head of the civil protection authority in the March region, Cesare Spuri, said there have been reports of buildings collapsing in many cities.
« We are trying to understand if people are under the rubble, » Spuri said.
In Norcia, nuns knelt in prayer and a firefighter appealed to a priest to help maintain calm among dozens of residents gathered there, including some in wheel chairs.