An American couple found dead in their Dominican Republic hotel room while on vacation last week both suffered from respiratory failure, the country’s national police said. 

Edward Nathaniel Holmes, 63, and Cynthia Ann Day, 49, of Prince George’s County, Maryland, were reportedly found unresponsive in their room Thursday at Grand Bahia Principe Hotel in La Romana, roughly 75 miles east of Santo Domingo.

Hotel staff members discovered their bodies in the room after the couple missed their scheduled checkout time and immediately contacted the local authorities, according to a statement released by the hotel group.

Holmes and Day each died of respiratory failure and pulmonary edema, a condition caused by excess fluid in the lungs, Dominican police said. Hotel staffers reportedly did not find any signs of violence.

Police said they discovered various bottles of medications used to treat high blood pressure in their room. Authorities are still waiting for the results of toxicology tests. 

Holmes and Day had been staying at the resort since May 25, according to the hotel.

“I love you and truly I am going to miss you, more than words can fully express the true extent of my grief,” one of Holmes’ Facebook friends wrote on his page. “May the two of you rest in eternal peace.”

The U.S. State Department said it’s working with local authorities on the investigation into the deaths.

“We offer our sincerest condolences to the family on their loss,” the department said in a statement. “We are in close contact with local authorities regarding their investigation into the cause of death. We stand ready to provide all appropriate consular assistance.”

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The State Department issued a travel advisory for the Dominican Republic in April due to crime.

“Violent crime, including armed robbery, homicide and sexual assault is a concern throughout the Dominican Republic,” the advisory said. “The wide availability of weapons, the use and trade of illicit drugs, and a weak criminal justice system contribute to the high level of criminality on the broader scale.”

A Delaware woman last month said she was brutally assaulted and left for dead while vacationing with her husband in January at Majestic Elegance resort in Punta Cana, about 70 miles east of La Romana.

Tammy Lawrence-Daley alleged an unidentified man wearing a uniform with the resort’s logo attacked her from behind, locked her in a maintenance room and beat her for eight hours. Daley and her husband have accused the resort and Dominican police of dragging their feet in the investigation of the incident.

Dominican police announced in April that a New York couple vacationing in the Caribbean country had likely died in a car crash on their way to the airport on March 27. Orlando Moore and his girlfriend Portia Ravenelle had been reported missing for two weeks before their deaths were confirmed by Dominican authorities.

Ravenelle was found on the road the day of the crash, but died eight days later in a local hospital, according to Dominican police. Moore’s body was found at sea in an advanced stage of decomposition days after the wreck, they said.

“I am saddened it took this many days to find out,” family friend Francesca Figueroa told CNN last month. “[Ravenelle] had to die by herself … when one of us could have been there holding her hand.”

This story has been updated with information about the deaths of Orlando Moore and Portia Ravenelle.