The three-storey building was reportedly housing 167 people when the fire started in the early morning hours.

“It was a hellish scene,” local resident Lucia, who can see the home from her house, told reporters.

“We saw old people protecting their faces with wet rags,” and windows had been cracked by the heat, she said.

The cause of the blaze was not yet known, the fire brigade said.

Over 10 ambulances, various fire trucks and a silver mortuary van could be seen outside the building in the south of the Italian city.

“Six people killed, numerous (others) suffering from smoke inhalation hospitalised. Dozens of people saved by firefighters who immediately evacuated the building,” the fire brigade said on Twitter.

Some eighty people were rushed to hospital, two of whom were fighting for their lives, Milan’s fire chief Nicola Micele said.

Some 14 others were in a serious condition, Italian media said.

Five of the victims were women aged between 69 and 87 years old, while the sixth was a 73-year-old man, the reports said.

Italian Prime Minister Giorgia Meloni tweeted her “sincere condolences to the families of the victims and a speedy recovery” for those in hospital.

Carried to safety

Milan Mayor Giuseppe Sala said the fire “started in one room housing two female residents”, both of whom were killed by the flames.

“It did not spread, not even to the neighbouring rooms, but the smoke is just as deadly and the four other victims died of smoke inhalation”.

“It could have been worse, but six victims is a very heavy toll”, he said.

It was a member of staff who sounded the alarm at 1:20 am (2320 GMT Thursday) after spotting the smoke, officials said.

“Four teams of firefighters were immediately dispatched,” Sala added.

“They found themselves faced with very low visibility in a corridor inside one part of the building, and flames in one room”.

“They focused on putting out the flames, then evacuating the guests.

“It was a particularly complicated evacuation both because of the smoke and because some of the guests were not able to walk”.

The residents had to be evacuated “by being carried out, almost one and at time,” mayor Sala said.

They were given identifying bracelets and thermal emergency blankets.

The council was working to quickly re-house people in other suitable retirement homes.

The privately-run “Casa per Coniugi” caters to elderly people who are not self-sufficient but do not need hospital care.

Like many such homes, it was hit hard by the coronavirus pandemic, with 53 residents reported to have died with the virus by April 2020, the Corriere della Sera said.