A violent tornado tore down the roof of an Illinois theatre during a heavy metal concert on Friday night, killing one and hospitalizing 28 more after a series of violent twisters tore through the US.

The Midwest is waking up to devastation this morning inflicted by around 43 tornadoes across six states, according to preliminary reports from the Storm Prediction Center. 

As of Friday evening, three were also confirmed dead in Arkansas, bringing the total death toll to four, while hundreds more were injured.

The storm is expected to move east this weekend, with a tornado watch issued for parts of Indiana, Kentucky and Ohio.  

It comes after the only major trauma center in Arkansas - the University of Arkansas for Medical Sciences hospital - declared a level-1 mass casualty alert after a tornado struck Little Rock.

Authorities work the scene at the Apollo Theatre in Belvidere, Illinois,  after a severe spring storm caused damage and injuries during a concert,

Dramatic scenes saw cars flipping, roofs smashing and trees toppled across the South and Midwest while tens of thousands were left without power in Arkansas and Missouri. 

The Apollo Theatre in Belvidere, Illinois, saw its roof cave in at around 7.55pm local time when 260 people were inside.

The concert-goers had gathered to see the heavy metal band Morbid Angel.

Fire chief Shawn Schadle told reporters 28 people were taken to hospital with five in a serious condition.

One witness uploaded a video of the disturbing aftermath on Facebook.

'I was one of the first ones on the scene and I just started praying & crying,' Johnny Garner wrote on Facebook. 

'So many people being carried away it didn't look real.'

In Covington, Tennessee, five people were being treated in hospital after it was also hit by a twister. 

A spokesman for the Baptist Memorial Hospital-Tipton was not damaged by the storm and its staff were receiving and treating patients as of Friday night.