KYIV, Ukraine (AP) — Rescue operations stretched into a second day at a major Kyiv children’s hospital struck by a Russian missile, Ukraine President Volodymyr Zelenskyy said Tuesday, adding that 38 people were killed and almost 200 injured in an intense daytime barrage that smashed into cities across the country.

Zelenskyy said on the social platform X that 64 people were hospitalized in the capital as well as 28 in Kryvyi Rih and six in Dnipro — both in central Ukraine.

It was Russia’s heaviest bombardment of Kyiv in almost four months and one of the deadliest of the war, hitting seven of the city’s 10 districts. The strike on the Okhmatdyt children’s hospital, which interrupted open-heart surgery and forced young cancer patients to take their treatments outdoors, drew an international outcry.

Kyiv city administrators declared Tuesday an official day of mourning. Entertainment events were prohibited and flags lowered in the capital.

Russia denied responsibility for the hospital strike, insisting it doesn’t attack civilian targets in Ukraine despite abundant evidence to the contrary, including Associated Press reporting.

Kremlin spokesman Dmitry Peskov on Tuesday repeated that position, pointing to a Russian Defense Ministry statement that blamed a Ukrainian air defense missile for partially destroying the hospital.

The Russian onslaught Monday came on the eve of a NATO summit in Washington where alliance countries are expected to pledge new military and economic support for Ukraine.

Russian President Vladimir Putin, meanwhile, was hosting India’s Prime Minister Narendra Modi in Moscow.

New Delhi’s importance as a key trading partner has grown since the Kremlin sent troops into Ukraine in February 2022.

Zelenskyy was deeply critical of Modi’s visit, saying on X late Monday: “It is a huge disappointment and a devastating blow to peace efforts to see the leader of the world’s largest democracy hug the world’s most bloody criminal in Moscow on such a day.”

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Follow AP’s coverage of the war in Ukraine at https://apnews.com/hub/russia-ukraine