NEW YORK —

       At least 19 people, including nine children, died in a fire Sunday at a Bronx apartment building, the deadliest blaze in New York City in more than three decades.

       Stefan Ringel, a senior advisor to Mayor Eric Adams, confirmed the death toll. He said the children killed were 16 years old or younger.

       Thirteen people remained hospitalized in critical condition, Ringel said. In all, more than five dozen people were hurt. Most of the victims had severe smoke inhalation, fire Commissioner Daniel Nigro said.

       Adams called the fire’s toll “horrific.” At a news conference Sunday near the building, he said: “This is going to be one of the worst fires that we have witnessed during modern times.”

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       Firefighters “found victims on every floor and were taking them out in cardiac and respiratory arrest,” Nigro said. “That is unprecedented in our city.”

       Approximately 200 firefighters responded to the building on East 181st Street, around 11 a.m. Sunday. Initial reports said the fire was on the third floor of the 19-story building, with flames blowing out the windows.

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       News photographers captured images of firefighters entering the upper floors of the burning building on a ladder, multiple limp children being given oxygen after they were carried out and evacuees with faces covered in soot.

       Building resident Cristal Diaz, 27, told the New York Post she started putting wet towels at the bottom of her door after smelling smoke while drinking coffee in her living room.

       “Everything was crazy,” she said. “We didn’t know what to do. We looked out the windows and saw all the dead bodies they were taking with the blankets.”

       Sunday’s fire originated in a duplex apartment spanning the second and third floors, Nigro said. Firefighters found the door to the apartment open, he said, which apparently allowed the fire to quickly accelerate and spread smoke upward.

       The fire is not believed to be suspicious in origin but the cause is under investigation, officials said.

       The 120-unit residence is one of multiple buildings in the Twin Parks Northwest complex and was built in 1973 as part of a project to build modern, affordable housing throughout the Bronx.

       “Many of these buildings are old. Not every apartment has a fire alarm. Most of these buildings have no sprinkler system,” U.S. Rep. Ritchie Torres, a Democrat who represents the area, said on MSNBC. “And so the risk of a fire is much higher in lower income neighborhoods, in the Bronx, than it might be elsewhere in the city or in the country.”

       Nigro and Torres both compared the fire’s severity to a 1990 blaze at the Happy Land social club where 87 people were killed when a man set fire to the building after getting into an argument with his former girlfriend and being thrown out of the Bronx club.

       Sunday’s death toll was the highest for a fire in the city since the Happy Land fire. It was also the deadliest fire at a U.S. residential apartment building since 2017, when 13 people died in an apartment building, also in the Bronx, according to data from the National Fire Protection Assn.

       That fire started with a 3-year-old boy playing with stove burners and led to several law changes in New York City, including having the fire department to create a plan for educating children and parents on fire safety and requiring certain residential buildings to install self-closing doors.

       Sunday’s fire happened just days after 12 people, including eight children, were killed in a house fire in Philadelphia. The deadliest fire before that was in 1989 when a Tennessee apartment building fire claimed the lives of 16 people.