One person died in Benton, Ky., when he was thrown from his mobile home, the trailer apparently landed on him, and then caught on fire, reports Ryan Tate of CBS affiliate KFVS-TV.
Meteorologists said a cold front moving east collided with warm, unstable air to produce severe thunderstorms and funnel clouds across Kentucky, Indiana, Illinois and Tennessee. Tornadoes also were spotted in Indiana and Illinois.
"We heard a weird sound coming through, kind of a whistle," said Penny Leonard, 37, who sought shelter in the basement of a hospital in the western Kentucky town of Madisonville. "I thank God I'm safe."
Three people were reported in critical condition at the Regional Medical Center in Madisonville and several others were admitted due to storm injuries. The Hopkins County Emergency Management Agency estimates an F-3 tornado ripped a 3,000-foot-wide path through the area.
What made this outbreak different thanis it struck when most were awake and could get the tornado warnings, the Weather Channel's Mike Seidel said on CBS News' The Early Show.
"The same front that brought the severe weather and tornadoes on Tuesday heads to the East Coast today producing severe weather. That's forecast for New York, Philadelphia, Baltimore and Washington," said Seidel.
In some parts of the community, the roofs of homes were caved in, walls were blown out and entire buildings were blown off foundations. Some water pipes sticking from the ground gushed water.
Trees around the area were shorn off at the top, and chunks of wood were blown into sections of U.S. 41. Police cruisers and fire trucks lined the streets, setting up checkpoints.
Jayne Barton, a spokeswoman for the Regional Medical Center in Madisonville, said 22 people were treated for storm-related injuries ranging from minor cuts and bruises to head trauma.
"About that time it was a big loud train sound and glass and stuff just went flying," Benton homeowner Louise Brandon told KFVS. "I laid down by a recliner in the living room and that's when it took about half of my house, the garage, the car — everything."
In Tennessee, even Henry County's emergency officials had to scramble for shelter when their offices took a direct hit from a tornado. They moved into the county mayor's office in the courthouse in Paris, about 90 miles west of Nashville.
"It looked really big. And then above St. Paul we actually saw two more starting to funnel and they look three times the size the one that was going through," Shelbyville, Tenn., resident Vickie Settles told CBS affiliate WKRC.
"It sounded like a train coming through. I thought the house was going to leave there. Blown all the windows out, everything," added Jimmy Caperton of Wayne County to CBS affiliate WHNT.
Downed power lines and trees made many roads in the outlying areas of the county impassable, delaying searches by sheriff's deputies and officers for residents in the worst-hit areas.
"Numerous homes there were damaged, some completely destroyed," Henry County Sheriff's Department spokeswoman Faye Scott said. "It's major destruction."
The Henry County Medical Center treated 13 patients and admitted two with non-life threatening injuries, mostly cuts and bruises, said Sandra Sims, hospital spokeswoman.
In Tennessee's Montgomery County, the hardest hit area was Cunningham, just south of Clarksville. Four mobile homes, a camper and two houses were destroyed, while the Cunningham Market had its roof caved in by a tornado.
"It looks like a war zone," said Ted Denny, spokesman for the Montgomery County Sheriff's Department.
Forecasters said Tuesday's conditions were similar to those that produced a tornado on Nov. 6 that caused 41 miles of damage from Kentucky into the Evansville, Ind., area and killed 23 people.
Back in Madisonville, Ronnie Austin, 59, returned to a home split in two and blown off its foundation. His wife crawled out of the rubble and was taken to the hospital.
Austin said he had a generator and flood light and planned to stay at the house all night.
"I got too much stuff floating around. I'm just going to stay here all night and go through it in the morning," Austin said.