Two more residents of an Elizabeth City nursing home have died from complications associated with COVID-19, raising the death toll from the coronavirus in Pasquotank County to five.

Christy Saunders, Pasquotank-Camden Emergency Management coordinator, said the two people were residents of Elizabeth City Health & Rehabilitation, where 47 positive COVID-19 cases and four deaths from the virus have now been reported.

Albemarle Regional Health Services, the district’s health department, said both people who died were over 65. It did not release further details about either person.

ARHS Director Battle Betts said the agency was “extremely saddened” by their deaths.

“Our heart goes out to the family and friends of each individual,” he said in a press release. “The toll this virus continues to take on our community will have long lasting effects on everyone.”

A spokeswoman for ARHS said later on Monday that it “is undetermined” how the virus entered Elizabeth City Health and Rehabilitation, noting that “community spread is evident in the area.”

The two deaths in Pasquotank on Monday raise the number of people who’ve died from COVID-19 in ARHS-eight county region to 11. ARHS also reported the death of a third Bertie County resident on Saturday, saying the person was between the ages of 50-64 and had underlying health conditions. The agency has also reported two deaths in Perquimans County and one in Hertford County.

The number of COVID-19 cases in the eight-county region, meanwhile, rose to 243. Pasquotank continued to report the largest number of lab-confirmed cases of COVID-19, 81. More than half of those cases are at Elizabeth City Health & Rehabilitation, where at least 33 residents and 13 staff members have tested positive for the virus. Another 19 cases were reported at Pasquotank Correctional Institution, where all 19 inmates who tested positive for the virus have now recovered.

Of Pasquotank’s 81 cases, only 40 are still considered active, Saunders said.

Bertie and Hertford counties have reported the second- and third-largest number of cases: 61 and 51, respectively. Hertford County was the only county in the eight-county health district to report an additional case on Monday.

Elsewhere, Dare County reported three new lab-confirmed cases of COVID-19, raising its case total to 21. Dare’s Division of Public Health reported all three persons are Dare residents and contracted the virus through direct contact. Of Dare’s 21 cases, only six are considered active. One is hospitalized and the other five are recovering in home isolation, the Dare health department said. One other COVID-19 patient, a nursing home resident, died from complications from the disease.

Statewide, the number of lab-confirmed COVID-19 cases rose to 15,045 on Monday, an increase of 281. The number COVID-19 deaths rose to 550, an increase of three. Meanwhile, the number of persons hospitalized with the respiratory disease rose by 22 to 464 and the number of completed tests for the disease rose to 195,865, an increase of more than 3,700.