Police officers arrive at the Covenant School, Covenant Presbyterian Church in Nashville, Tennessee, on Monday. Reuters

Three children and two adults were killed in a shooting at a private Christian grade school in Nashville on Monday, hospital officials said.

While police said the suspect is dead after a confrontation with officers, it was not immediately clear whether the shooter was among the five people pronounced dead at the hospital.

The violence occurred at The Covenant School, a Presbyterian school for about 200 students from preschool through sixth grade. It was also not clear whether anyone else had been wounded Monday in the attack.

The killings come as communities around the nation are reeling from a spate of school violence, including the massacre at an elementary school in Uvalde, Texas, last year; a first grader who shot his teacher in Virginia; and a shooting last week in Denver that wounded two administrators.

The Nashville victims were pronounced dead upon arrival at the Monroe Carell Jr. Children’s Hospital, according to Craig Boerner, a spokesperson for Vanderbilt University Medical Center, which is affiliated with the children's hospital.

It was not immediately clear whether anyone else was wounded in the attack. Other students walked to safety on Monday, holding hands as they left their school surrounded by police cars, to a nearby church to reunited with their parents.

The shooter died after being "engaged by” officers, Metro Nashville Police said in a Twitter post. It was not immediately clear whether the shooter died by suicide or was shot by police.

The fire department said it responded to an "active aggressor” but did not give any specifics. Other details about the shooting were not immediately available.

Police officers with rifles, heavy vests and helmets could be seen walking through the school parking lot and around the grassy perimeter of the building Monday morning.

Helicopter footage from WTVF also showed the officers looking around a wooded area between the campus and a nearby road.

Reuters