Russia launched missiles at a children’s hospital in Kyiv, in a barrage that killed at least 20 people in a number of cities.

Explosions rang out and black smoke could be seen rising from the centre of Kyiv, according to reports.

Pictures distributed by officials from the children’s medical facility in Kyiv showed people digging through mounds of rubble, black smoke billowing over a gutted building and medical staff wearing blood-stained scrubs.

The rare daytime Russian barrage came as Volodymyr Zelensky was due in Warsaw before he flies to the Nato summit in Washington.

“Russian terrorists once again massively attacked Ukraine with missiles. Different cities: Kyiv, Dnipro, Kryvyi Rig, Sloviansk, Kramatorsk,” Mr Zelensky said, listing major civilians hubs in the south and east of the country.

“More than 40 missiles of various types. Residential buildings, infrastructure and a children’s hospital were damaged,” he wrote on social media.

Mr Zelensky said that there were an unknown number of people trapped under the rubble of the Okhmatdyt children’s hospital and it was not immediately clear how many had been killed.

Municipal officials said earlier that at least seven people had been killed in the barrage that hit Kyiv.

Russian forces have repeatedly targeted the capital with massive barrages since Moscow invaded Ukraine in February 2022, and the last major attack on Kyiv with drones and missiles was last month.

In Mr Zelensky’s hometown Kryvyi Rig, which has been repeatedly targeted by Russian bombardments, the strikes killed at least 10 and wounded over 30, the mayor said.

“In Dnipro, a high-rise building and an enterprise were damaged. A service station was damaged. There are wounded,” the Dnipropetrovsk governor Sergiy Lysak added.

In the eastern Donetsk region, where Russian forces have taken a string of villages in recent weeks, the regional governor said three people were killed in Pokrovsk - a town that had a pre-war population of around 60,000 people.

There was no immediate comment on the strikes from the Kremlin but it insists its forces do not target civilian infrastructure.

“This shelling targeted civilians, hit infrastructure, and the whole world should see today the consequences of terror, which can only be responded to by force,” the head of the presidential administration in Kyiv, Andriy Yermak, wrote on social media, following the attack.

Mr Zelensky and other officials in Kyiv have been urging Ukraine’s allies to send more air defence systems, including Patriots, to the war-battered country to help fend off fatal Russian aerial bombardments.

“Russia cannot claim ignorance of where its missiles are flying and must be held fully accountable for all its crimes,” Mr Zelensky said in another post on social media.