AMATRICE, Italy — Rescue workers battled against time to find survivors from an earthquake that struck central Italy before dawn Wednesday, as the death toll reaches 120, according to Prime Minister Matteo Renzi.

During a visit to the affected region Wednesday evening, Renzi said at least 120 had died “and this toll is not final.”

“It is a pain without limits,” he said. A total of 368 injured and sick people had been rescued from the two worst-hit villages, Amatrice and Accumoli, after the earthquake of a magnitude of at least 6 struck.

Italy was now standing together in solidarity to overcome the great challenges it faces after the quake, Renzi said. Dozens of people are still missing with hopes of finding them alive fading. It is feared the death count could rise further as many victims are trapped under rubble.

“This is a town that is dead. It’s completely destroyed,” Federico Rocchi, a student in his 20s told dpa in Amatrice, one of the worst-hit towns. He said that he had lost many friends.

The quake was felt as far away as Rome, which lies about 93 miles southwest of the epicenter, which lay at a depth of 2 miles in a wooded area in the province of Rieti. It was followed by more than 50 aftershocks, the strongest a 5.4 magnitude quake.

“We will leave nobody on their own,” Renzi pledged earlier in the day as he thanked people — including many who had searched for survivors with their bare hands — for aiding the rescue effort.

“Many are still trapped under the rubble,” Amatrice Mayor Sergio Pirozzi told ANSA. “We’re preparing a spot for the bodies.”

“Half of the town is gone,” Pirozzi told public broadcaster Rainews 24.

Resident Eraldo Di Giacomo spoke of major devastation: “Everything has collapsed, houses, everything,” he said in an interview with the same network. “Everything is broken.”

Amatrice’s hospital was evacuated, and its 15 patients were moved out into the street. People injured from the earthquake were also taken there. But there were also signs of hope.

One boy was pulled alive from the rubble in the town of Pescara del Tronto. Doctors also freed a 6-year-old boy from the rubble in Amatrice, though his twin brother remained missing, reported ANSA.

Speaking to Rainews 24 two hours after the quake hit, Accumoli Mayor Stefano Petrucci complained that emergency services had not yet arrived, putting lives at risk because locals were ill-equipped to search for survivors.

“It is a scandal,” Petrucci said, noting that a Carabinieri police unit had managed to reach the town from 62 miles away.

The German Red Cross said rescue work would be difficult because of the region’s mountainous terrain.

“Rescue workers are moving in an environment that is difficult [to navigate], not only because of the rubble but also because of the terrain, which is partially at risk of collapse or landslide,” said mountain rescue official Klemens Reindl.

The European Union offered whatever aid it could, including access to satellite navigation services to better survey the scene.

“We stand, as ever, in solidarity with the Italian nation and are ready to assist in any way we can,” tweeted European Commission President Jean Claude Juncker.

Italian President Sergio Mattarella appealed for solidarity during a “moment of pain and of appeal to common responsibility.”

“The immediate need is to engage all forces to save lives, care for the wounded and ensure the best conditions for the displaced,” he said.

The disaster has already prompted an outpouring of sympathy. Pope Francis said he was nearly at a loss for words.

“Hearing the mayor of Amatrice saying that the town doesn’t exist any more and knowing that there are children among the victims has moved me deeply,” he said.

Chancellor Angela Merkel also reached out.

“In the face of the extreme suffering and the massive destruction I would like to convey to you the deep sympathy of the German people,” Merkel wrote in a condolence telegram to Renzi.

The disaster is not far from the city of L’Aquila, where a 5.9 magnitude quake killed 309 people seven years ago. However, there was hope that the death toll would be lower Wednesday, as the worst-struck areas were less populated than L’Aquila in 2009.

In Rome, archaeologists were gathering at the Coliseum to determine if Italy’s most famous monument had suffered any damages amid the aftershocks. The tourist attraction remained open to visitors.

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