ABSTRACT: With the continuous spread of the COVID-19 pandemic, an increasing number of patients have been admitted to the ICU with severe respiratory complications requing prolonged supine positioning . Recently, many case reports have been published regarding dermatological manifestations associated with the COVID-19 disease . Yet, there is little information about the clinical features . Pyoderma gangrenosum (PG) is an ulcerative noninfectious inflammatory disease of the skin . At least in 50% of the cases the etiology is unknown . Nevertheless, PG has been known to be associated with many systemic diseases . In this paper, the authors report a case series of two critically ill patients with COVID-19 who developed sacral ulcers during their recovery at the ICU . These ulcers had an atypical course showing an exacerbation after surgical debridements . Thus, PG was suspected and confirmed by the clinical evolution and biopsies taken from the wounds . To the best of the authors' knowledge, no previous papers have reported sacral pressure injuries associated with pyoderma gangrenosum in patients with COVID-19 . PG should be suspected in those with COVID-19 who developed nonhealing pressure injuries.