JOPLIN, Mo. (AP) — A massive tornado that tore a 6-mile path across southwestern Missouri killed at least 89 people as it slammed into the city of Joplin, ripping into a hospital and leaving a forest of splintered tree trunks behind where entire neighborhoods once stood.

Authorities warned that the death toll could climb Monday as search and rescuers continued their work at sunrise.

City manager Mark Rohr announced the number of known dead at a pre-dawn news conference outside the wreckage of a hospital that took a direct hit from Sunday's storm. Rohr said the twister cut a path nearly 6 miles long and more than a half-mile wide through the center of town, adding that tornado sirens gave residents about a 20-minute warning before the tornado touched down on the city's west side.

Joplin Missouri Tornado May 22, 2011Much of the city's south side was leveled, with churches, schools, businesses and homes reduced to ruins.

Fire chief Mitch Randles estimated that 25 to 30 percent of the city was damaged, and said his own home was among the buildings destroyed as the twister swept through this city of about 50,000 people some 160 miles south of Kansas City.

Residents said the damage was breathtaking in scope.

"You see pictures of World War II, the devastation and all that with the bombing. That's really what it looked like," said Kerry Sachetta, the principal of a flattened Joplin High School. "I couldn't even make out the side of the building. It was total devastation in my view. I just couldn't believe what I saw."

The Joplin twister was one of 68 reported tornadoes across seven Midwest states over the weekend, from Oklahoma to Wisconsin, according to the National Weather Service's Storm Prediction Center. At least one person was killed in Minneapolis. But the devastation in Missouri was the worst of the day, eerily reminiscent the tornadoes that killed more than 300 people across the South last month.

Among the worst-hit locations in Joplin was St. John's Regional Medical Center. The staff had just a few moments' notice to hustle patients into hallways before the storm struck the nine-story building, blowing out hundreds of windows and leaving the facility useless.

Joplin Missouri Tornado May 22, 2011

A destroyed helicopter lies on its side in the parking lot of the Joplin Regional Medical Center in Joplin, Mo., Sunday, May 22, 2011. A large tornado moved through much of the city, damaging the hospital and hundreds of homes and businesses. (AP Photo/Mark Schiefelbein)

More images of the destruction wrought on this small town appear on the following pages.

Joplin Missouri Tornado May 22, 2011

Residents of Joplin, Mo., walk west on 26th Street near Maiden Lane after a tornado hit the southwest Missouri city on Sunday evening, May 22, 2011. The tornado tore a path a mile wide and four miles long destroying homes and businesses. (AP Photo/Mike Gullett)

Joplin Missouri Tornado May 22, 2011

Residents begin digging through the rubble of their home after it was destroyed by a tornado that hit Joplin, Mo. on Sunday evening, May 22, 2011. (AP Photo/Mike Gullett)

Joplin Missouri Tornado May 22, 2011

Damaged vehicles litter the parking lot of St. John's Hospital in Joplin, Mo. A massive tornado blasted its way across southwestern Missouri on Sunday, flattening several blocks of homes and businesses in Joplin and leaving residents frantically scrambling through the wreckage. (AP Photo/Mike Gullett)

Joplin Missouri Tornado May 22, 2011

A man carries a young boy who was rescued after being trapped in his home after a tornado hit Joplin, Mo. on Sunday evening, May 22, 2011. (AP Photo/Mike Gullett)

Joplin Missouri Tornado May 22, 2011

A man walks past destroyed vehicles in the parking lot of a Joplin, Mo. business. (AP Photo/Mark Schiefelbein)

Joplin Missouri Tornado May 22, 2011

Destroyed vehicles are piled on top of one another in the parking lot of the Joplin Regional Medical Center in Joplin, Mo., Sunday, May 22, 2011. A large tornado moved through much of the city, damaging the hospital and hundreds of homes and businesses. (AP Photo/Mark Schiefelbein)

Joplin Missouri Tornado May 22, 2011

Rescuers and neighbors look through the the wreckage of destroyed homes on a hillside in Joplin, Mo., Sunday, May 22, 2011. (AP Photo/Mark Schiefelbein)

Joplin Missouri Tornado May 22, 2011

Emergency personnel walk through a neighborhood severely damaged by a tornado near the Joplin Regional Medical Center in Joplin, Mo., Sunday, May 22, 2011. (AP Photo/Mark Schiefelbein)

Joplin Missouri Tornado May 22, 2011

People walk down a street lined with destroyed homes in Joplin, Mo., Sunday, May 22, 2011. (AP Photo/Mark Schiefelbein)

Joplin Missouri Tornado May 22, 2011

Damage to St. John's Regional Medical Center in Joplin, Mo. is shown after it was hit by a tornado on Sunday, May 22, 2011. (AP Photo/The Wichita Eagle, Jaime Green)

Joplin Missouri Tornado May 22, 2011

People pass the Joplin Regional Medical Center after it sustained a direct hit from a tornado in Joplin, Mo., Sunday, May 22, 2011. A large tornado moved through much of the city, damaging a hospital and hundreds of homes and businesses. (AP Photo/Mark Schiefelbein)

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