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0·07]) and external validation (NIV group value 0·88 [95% CI 0·72-0·96], HFNC group value 0·86 [0·72-0·93]). We have developed a nomogram and online calculator that can be used to identify patients with COVID-19 who are at risk of NIRS failure. These patients might benefit from early triage and more intensive monitoring. Ministry of Science and Technology of the People's Republic of China, Key Research and Development Plan of Jiangsu Province, Chinese Academy of Medical Sciences. Ministry of Science and Technology of the People's Republic of China