Iran’s health ministry Friday reported two more deaths among 13 new cases of coronavirus in the Islamic republic, bringing the total number of deaths to four and infections to 18.

“Thirteen new cases have been confirmed,” ministry spokesman Kianoush Jahanpour said on Twitter. “Unfortunately two of them have lost their lives.”

The COVID-19 outbreak first appeared in Iran on Wednesday, when officials said it killed two elderly people in the Shiite holy city of Qom, the first confirmed deaths from the disease in the Middle East.