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UPDATE - 5 people killed and 40 structures collapsed as destructive tornado hits Nashville City

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Five people were killed across Middle Tennessee after a large and dangerous tornado tore through the state early Tuesday morning.

Three people died in Putnam County, Sheriff Eddie Farris confirmed to CNN affiliate WTVF. Putnam County is about 100 miles east of Nashville.

Two deaths were reported in East Nashville, a tweet from the Metro Nashville Police Department said.

The Nashville Fire Department is responding to approximately 40 structure collapses around the city, according to a tweet from the agency.

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Officers who specialize in urban search and rescue are being called in, MNPD said. Rescuers are focusing their efforts in Germantown, East Nashville and Hermitage, according to Joseph Pleasant, spokesman with the Nashville Office of Emergency Management.

Nashville Mayor John Cooper told WTVF there are about 20 people in the hospital following the tornado.

"There are a couple of tragic cases, in one case a tree falling on a car and there are also I believe about 20 people in the hospital, so we need to monitor that very carefully," Cooper said. "We all worry about some people being left in some buildings that have been damaged and I know the first responders are working their way through that problem."

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The National Weather Service reported a tornado was located near Nashville at 12:38 a.m. CST, moving east about 45 mph, the agency said.

Police in Mt. Juliet, a suburb 20 miles east of Nashville, are searching for injured people. "There are multiple homes damaged and multiple injuries. We have requested mutual aid from allied agencies. We continue to search for injured," a tweet from the department said.

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A shelter has been opened for those displaced by the tornado at the Victory Baptist Church on Tate Lane in Mt. Juliet, according to a tweet.

In Putnam County, there are "several critically injured" people, county Mayor Randy Porter told CNN in a Facebook message. The county suffered damage to several homes and power lines, he said.

In a Facebook post, Putnam County Sheriff's Department confirmed a tornado touched down between the city limits of Cookeville and Baxter.

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The Putnam County Sheriff Department says some of the worst hit areas are in Charleton Square, Plunk Whitson, Echo Valley, Prosperity Point.

Several injuries have been reported in the city of Cookeville, Mayor Ricky Shelton said.

The Cookeville Community Center has been opened as an emergency shelter, Porter said in a Facebook post.

Nashville Office of Emergency Center has partially activated to respond to the damage from severe weather, according to a tweet from the center. They've opened an emergency shelter at the Farmers Market on Rosa L. Parks Blvd. The Red Cross has been notified and is responding to help displaced residents, the EOC said.

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At least two blocks of multi-story buildings are shown with their windows blown out in the Germantown area of downtown Nashville, images from WTVF show.

Scraps of wood and metal lined the street as people stood outside in their pajamas with their pets surveying the damage.

Windows were blown out of a building following a tornado in Nashville.

A resident of the area impacted by the tornado, who didn't give her name, told WTVF she was woken up by the tornado as it tore the roof off part of her building.

"It just woke you out of your sleep," she said. "I'm lucky my side didn't get torn off. The other side is totally torn off."

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"When you're inside it's one thing, but to walk outside and see this it's bad," the woman told the affiliate.

The storm has since cleared the Nashville area and the tornado warning has expired, but tornado warnings were issued by the National Weather Service throughout Tennessee until 6 a.m. CST Tuesday. Heavy rains will continue in Nashville this morning with the potential for flooding as another strong line of storms moves through the metro area.

Investigators with the National Weather Service will survey the damage and confirm the tornado's intensity later today.

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