L'Aquila, Italy  - Rescue workers, paramedics and soldiers spread out across central Italy Monday, sifting through the remains of buildings that were nearly decimated by an earthquake that struck in the pre-dawn hours.

The quake, which reportedly reached 6.2 on the Richter scale, left 90 people dead in a region about 90 kilometres north-east of Rome, according to the Italian news agency Ansa, citing rescue workers.

In the city centre of L'Aquila, one of the towns worst hit by the earthquake, a gigantic crane attempted to lift a large, broken slab of concrete from a heavily damaged building which served as accommodation for university students from out of town.

Officials said at least five people who remained unaccounted for more than 10 hours after the earthquake struck may have been trapped in the building. Onlookers included a group of relatives and friends, some of them weeping, as well as dozens of journalists and television camera operators.

Of the building's five storeys, only three remained visible, the lower two having sunk into the ground.

"Some of the students go away for weekends, so we don't know how many people were in the building on Sunday night," said Renzo Fabiani, a doctor from the Aquila's main San Salvatore hospital.

Earlier, medical staff began evacuating hundreds of patients from the hospital because of a shortage of drinking water caused by broken pipes.

By midday, hundreds of people had gathered at an athletics field which rescuers had transformed into a reception camp. Volunteers distributed bottled water and loaves of bread.

"We fled our home in the city centre after the main tremor at three o'clock this morning, I'm not sure if my neighbours were so lucky," said a woman, her nightdress visible from underneath a tracksuit top.

Nearby, a group of nuns sat in a mini-van, one of them praying.

"They are probably worried about their sisters in the cloistered convent in Paganica," said the woman in the nightdress, referring to the town near Aquila which, according to reports, bore the brunt of the earthquake.

Ambulances and military vehicles continued to drive through the otherwise deserted inner city's winding streets, negotiating their steep rises and bends. The hilly nature of Aquila's terrain has made it difficult for rescuers to position cranes as well as their vehicles.

"My family were about to go to bed when the first shock hit us at 11," said Antonio Nardicchia. "We stood outside the building for a while, but then returned inside. We've felt so many of these shocks in recent months.

"But then I was woken up by a much bigger one, the whole house was shaking. As we went outside we could see plaster and mortar break off some of the surrounding buildings.

"I looked towards the top of the Hotel Duca D'Abruzzi, and all I could see were metal poles sticking out where the top floor had been," Nardicchia said.

Mild after shocks continued to shake L'Aquila throughout the day.

An estimated 50,000 people were homeless across the region in the aftermath of the earthquake, torn from their sleep and wandering the street, according to civil defence officials, who also reported 1,500 people were injured in the quake.

Many more dead were feared under rubble after thousands of homes were wrecked or left dangerously cracked. (dpa)