And in Jackson, Tenn., rescuers had to dig students out from the wreckage of Union University's damaged dorms. A school spokesman said eight students had been trapped, but none was injured seriously. More than 50 students were taken to hospitals.
Tim Ellsworth, the school's news director, said the dorms had been "reduced to piles of rubble. I know we had students huddled in the bathrooms."
"A couple of buildings have almost completely collapsed and the roof of Jennings Hall is almost completely gone," he said.
A tornado's direct hit on a natural gas pumping station outside of Nashville triggered a spectacular fire. Power was knocked out in the nearby area and the hospital was running on generators. Only the emergency room had lights on.
In Memphis, high winds collapsed the roof of a Sears store at a mall. Debris that included bricks and air-conditioning units was scattered on the parking lot, where about two dozen vehicles were damaged.
A few people north of the mall took shelter under a bridge and were washed away, but they were pulled out of the Wolf River with only scrapes, said Steve Cole of the Memphis Police Department.
An additional seven people died in Kentucky and four more in Alabama, officials said.
Across the tornadoes' paths, emergency workers scrambled to find survivors and state officials said the efforts had just begun.
"Many of our citizens will be hurting and many will be hurting for days to come," one Tennessee official said.
Daylight should aid the searches and allow them to get into more places to reach victims along with survivors.
The total monetary tally has yet to be determined, but with all the structural damage the storm could be costly.