Incidence and risk factors of pressure injuries in critically ill patients with COVID-19.

This was a retrospective single-centre study based on records, so data may be incomplete and the findings may not apply to other hospitals. Some key data were missing: Braden risk was available for 603 patients and nutritional risk for 630. The study included only patients with COVID-19, so it cannot show that COVID-19 itself caused the higher pressure injury incidence. Many patients received several ICU supports at once, such as mechanical ventilation, sedation, neuromuscular blockers, prone positioning and devices, so the independent effect of any single support cannot be separated. The Braden Scale is widely used but not specific for critically ill adults; it had moderate predictive validity, good sensitivity and low specificity in a prior review. Pandemic workload, supply shortages and limited implementation of prevention measures may have influenced the incidence.

Do not conclude that mechanical ventilation caused pressure injuries or that the ICU prevention bundle reduced them. This was a retrospective observational study in one ICU, and patients often received mechanical ventilation, sedation, neuromuscular blockers, prone positioning and devices together, so the contribution of any single component cannot be separated.