At least 210 people in Iran have died as a result of the new coronavirus disease, sources in the country's health system have told BBC Persian.
Most of the victims are from the capital, Tehran, and the city of Qom, where cases of Covid-19 first emerged.
The figure is six times higher than the official death toll of 34 given by the health ministry earlier on Friday.
There was no comment from the Iranian government, but it has insisted it is being transparent about the outbreak.
Ministry spokesman Kianush Jahanpur rejected the BBC report in a tweet. Even at 34, Iran has had the highest death rate from the outbreak outside China.
US Secretary of State Mike Pompeo said the United States had offered to help with the coronavirus response in Iran, raising doubts about Tehran's willingness to share information.
Iran said the offer was ridiculous.
US President Donald Trump pulled out from a multilateral nuclear deal with Iran in 2018 and reimposed sanctions which have battered the Islamic Republic's economy.
"The claim to help Iran in dealing with coronavirus, from a country which with its economic terrorism has created widespread pressure for the people of Iran and even closed the paths for buying medicine and medical equipment, is a ridiculous claim and a political-psychological game," Iran's foreign ministry spokesman, Abbas Mousavi, said, according to the Mehr news agency.
A member of parliament for Qom accused the authorities of a cover-up earlier this week and the US has expressed concern that they may not be sharing information.
There have been more than 83,000 reported cases of Covid-19 worldwide and 2800 deaths since the disease emerged late last year - the vast majority in China.
Global risk raised to highest level
The risk of spread and impact of the coronavirus is now "very high" at a global level, the highest level of alarm, but containment is still possible, the World Health Organisation (WHO) says.
WHO chief Tedros Adhanom Ghebreyesus said it would be a "big mistake" to switch from a public health strategy of containment to mitigation, where authorities accept the virus is spreading.
In the last few days, 24 cases had been exported from Italy to 14 countries and 97 cases had been exported from Iran to 11 countries, Tedros said.
"Our epidemiologists have been monitoring these developments continuously. We have now increased our assessment of the risk of spread and the risk of impact of COVID-19 to 'very high' at global level," he told a news briefing.
"We do not see evidence as yet that the virus is spreading freely in communities. As long as that is the case we still have a chance of containing this virus."
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China's 329 reported cases in the past 24 hours was the lowest there in more than a month, he said.
"We are on the highest level of alert and highest level in terms of spread and of impact. But that is not in order to alarm or scare people," said Dr Mike Ryan, executive director of WHO's emergencies programme.
"People need to take a reality check now and really understand an all-of-government, an all-of-society approach is needed," Dr Ryan said.
"We have been dealing with this virus for two months and I think this is a reality check for every government on the planet - wake up, get ready...You have a duty to your citizens, you have a duty to the world to be ready."
The WHO mission to Iran has been delayed due to "issues with getting flights and access to Iran right now", Dr Ryan said, but the government of the United Arab Emirates was helping to facilitate access and delivery of supplies.
"The UAE is helping with this. We hope Sunday at the earliest, if not by Monday, we should have people on the ground," Tedros said.
Dr Ryan said Nigeria, whose first case was confirmed as an Italian man who arrived from Milan, had "well-tested mechanisms for dealing with these dangerous pathogens", citing experience with Lassa fever and cholera.
The most populous African country has expanded its influenza diagnostics and the same labs can now do Covid diagnosis, he said.
"That is not to say that there are not risks. Nigeria is a vast country with a huge population, and it has many vulnerable people, especially in the north and lots of refugees and many others.
"So it is disappointing to see the disease arrive, but it's also heartening to see that the disease was picked up and a single importation was confirmed quickly. And that isolation and other activities have already begun," Dr Ryan said.
Mexico has become the second country in Latin America to report cases: "There is no reason to think [the virus] would act differently in different climate settings," said Dr Maria van Kerkhove, a WHO epidemiologist.
-BBC / Reuters