Today's announcement means at least 70 Covid-19 patients died in hospitals across the Black Country, Birmingham and Staffordshire in the seven days to Monday - the highest weekly total since May, with further deaths likely to be announced.
Among the deaths announced today were three in Dudley and four in Staffordshire, the two boroughs which are set to have Tier 2 restrictions imposed on them this week.
Talks are also due to take place between local authority leaders and ministers next week, with the possibility of the whole region moving into Tier 3 "very high" level due to climbing infection rates.
Currently Wolverhampton, Walsall, Sandwell, Solihull and Birmingham are designated as Tier 2 "high" risk but Staffordshire and Dudley are Tier 1 "medium" risk.
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Three more deaths were also confirmed in Walsall, while 11 were in hospitals across Sandwell and Birmingham.
The 21 new deaths take the total number of Covid-19 patients to have died in hospital in the Black Country, Birmingham and Staffordshire since the pandemic began to 2,773.
A further 717 people have died in the region's care homes after contracting the disease, although any coronavirus deaths in March are not included in these statistics.
Meanwhile 1,819 more people have tested positive for Covid-19 in the region, according to the latest government figures, while the UK-wide death toll has increased by 367 to 45,365. This includes deaths in and out of hospitals but only those that took place within 28 days of a positive test.
Across the region
Six patients were confirmed to have died at Sandwell and West Birmingham Hospitals NHS Trust, which runs Sandwell General and City hospitals, taking the death toll at the trust to 420.
Three deaths were announced at The Dudley Group NHS Foundation Trust, which runs Russells Hall Hospital, where the total is now 281.
At University Hospitals Birmingham NHS Foundation Trust, which runs Queen Elizabeth, Heartlands, Good Hope and Solihull hospitals, five more patients have died making a death toll of 1,063.
Four more patients have died at University Hospitals of North Midlands NHS Foundation Trust, which runs Stafford County and Stoke Royal hospitals, bringing the trust's total to 390.
And three new deaths were confirmed at Walsall Healthcare NHS Trust where the toll rose to 243.
No more deaths were announced at The Royal Wolverhampton Trust, which runs New Cross and Cannock Chase hospitals, where the total stands at 306.
A spokesman for NHS England said: "A further 174 people, who tested positive for the Coronavirus (Covid-19) have died, bringing the total number of confirmed reported deaths in hospitals in England to 32,291.
"Patients were aged between 33 and 102 years old. All except four (aged 61 to 87 years old) had known underlying health conditions.
"Date of death ranges from 27 March to 27 October 2020, with the majority being on or after 20 October.
"Their families have been informed."