Amongst the 35 coffins laid out in a sports hall were small caskets holding the bodies of an 18-month-old baby and a nine-year-old girl, two of the 21 children who are known to have died when the quake hit central Italy early on Wednesday.

"Don't be afraid to bewail your suffering, we have seen so much suffering. But I ask you not to lose your courage," Bishop Giovanni D'Ercole said in a homily in the hall, which was packed with grieving families and the nation's top politicians.

"Only together can we rebuild our houses and churches. Above all, together we can give life back to our communities," he said, speaking in front of a dusty crucifix salvaged from one of dozens of churches devastated by the quake.

Even as the funeral Mass was being held, rescuers kept searching through the rubble of the worst hit town, Amatrice, although they acknowledged they had little hope of finding any more survivors from Italy's worst earthquake in seven years.

Nine more bodies were recovered from the town on Saturday, including three corpses that were pulled overnight from the crumpled Hotel Roma, bringing the death toll in Amatrice alone to 230 residents and tourists.

One of the last people to be plucked alive from the debris was a girl called Giorgia, who turned four on Saturday. Her sister Giulia's small coffin lay in the center of the sports hall for the funeral Mass.

Relatives of the dead sat on chairs next to the coffins or knelt on the floor, their arms resting on the varnished wood caskets, which were covered in flowers. Some of the mourners clutched framed photos of their loved ones.

As the names of the dead were read out, hundreds of people gathered outside the sports hall broke into prolonged applause in a sign of solidarity with the families.

INVESTIGATION

Italian President Sergio Mattarella flew to Amatrice by helicopter on Saturday to see the damage for himself before traveling on to the nearby city of Ascoli Piceno for the funeral. He was joined by Prime Minister Matteo Renzi, parliamentary chiefs and local mayors.

Further funerals will be held in the coming days, including in the capital Rome, where almost 50 of the dead came from.

Authorities have released the names of 181 victims. The youngest was five months old, the oldest 93.

Six Romanians, three Britons, a Spanish woman, a Canadian and an Albanian also died in the calamity. The area is popular with vacationers and authorities are still struggling to pin down how many visitors were there when the quake hit.

Most of the buildings in the quake zone had no anti-seismic protection, but even some of those that did, including a school in Amatrice that was renovated in 2012, fell apart.

Magistrates have opened an investigation into some of the incidents, including the collapse of a belltower in the town of Accumoli, which smashed through the roof of an adjacent building killing a family of four.

"What happened cannot just be considered fate," said prosecutor Giuseppe Saieva, who is leading the probe. "If these buildings had been constructed like they are in Japan then they would not have collapsed," he told la Repubblica newspaper.

Renzi has promised to rebuild the shattered communities and the mayor of Amatrice urged the government to learn the lesson of painfully slow post-quake reconstructions of the past.

"What we need is a reconstruction in record time. It is a great opportunity for politicians to show extraordinary commitment," mayor Sergio Pirozzi told president Mattarella.

Aftershocks continued to rattle the area overnight, the strongest measuring 4.2. The Italian geological institute said some 1,332 aftershocks have hit Italy's central mountains since Wednesday's pre-dawn 6.2 magnitude quake.

Italy sits on two fault lines, making it one of the most seismically active countries in Europe. Almost 30 people died in earthquakes in northern Italy in 2012 while more than 300 died in the nearby city of L'Aquila in 2009.