Turkey’s disaster and emergency management agency (AFAD) said in a series of tweets early on Saturday that five people were pulled alive from the rubble in Elazig province.
The magnitude 6.8 quake struck at 8:55pm local time (17:55 GMT), at a depth of 6.7km near the town of Sivrice, according to AFAD, and was followed by several aftershocks, the strongest with magnitudes 5.4 and 5.1.
Among those saved was a pregnant woman rescued 12 hours after the quake had struck, the official Anadolu news agency said. At least 30 others remain missing, it added, quoting Health Minister Fahrettin Koca.
Interior Minister Suleyman Soylu told reporters on Saturday that at least 18 people were killed in Elazig and four more in the neighbouring province of Malatya. Some 920 people injured were in hospitals in the region, according to authorities.
About 30 buildings had collapsed from the quake in the two provinces, Murat Kurum, the environment minister, said.
Turkish President Recep Tayyip Erdogan said on Twitter that all measures were being taken to “ensure that the earthquake that occurred in Elazig and was felt in many provinces is overcome with the least amount of loss”.
People in Elazig whose homes were damaged or were too afraid to go indoors were being moved to student dormitories or sports centre amid freezing conditions.
“It was very scary, furniture fell on top of us. We rushed outside,” 47-year-old Melahat Can, who lives in the provincial capital of Elazig, told AFP news agency.
Eray Ernek described how he was watching television when the quake took place. “I was on the sofa and then fell on the floor. My sleeping father was woken up.
“After we found a way out, we broke the door and got out. We saw other houses had collapsed.”
AFAD warned residents not to return to damaged buildings because of the danger of further aftershocks. It said beds, blankets and tents were being sent to the area where some people sheltered in sports gymnasiums.
Al Jazeera’s Sinem Koseoglu, reporting from Elazig, said people affected by the quake spent the night either in the cars or in freezing temperatures outside.
“It is difficult to say exactly how many buildings have been damaged. People are now waiting to see their loved one being pulled out of the rubble.”
Elazig Governor Cetin Oktay Kaldirim told NTV television that a fire broke out in a building in Sivrice but was quickly brought under control.
NTV said the earthquake was felt in several Turkish provinces and sent people running outdoors in panic.
Turkey sits on top of two major faultlines and earthquakes are frequent. Two strong earthquakes struck northwest Turkey in 1999, killing around 18,000 people.
A magnitude 6.0 earthquake killed 51 people in Elazig in 2010.
Al Jazeera and news agencies