Inclusion Criteria:  - Alert and conscious adults with the age of > 18 years old Severe COVID-19 pneumonia  o SpO2 <94% on room air at sea level, respiratory frequency >30 breaths/min, or lung infiltrates >50%  Received tocilizumab within 10 days prior to enrollment Tocilizumab is co-admisnitered with a systemic corticosteroid Agree to sign conflict of interest  Exclusion Criteria:  - Severe COVID-19 pneumonia requiring invasive mechanical ventilation Creatinine clearance < 30 mL/min End stage renal disease on hemodialysis ALT and/or AST > 5 upper limit of normal Pregnancy Lactation To prevent colchicine toxicity, patients receiving a strong CYP3A4 inhibitor (eg clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, atazanavir), a moderate CYP3A4 inhibitor (eg diltiazem, verapamil, fluconazole, amprenavir, aprepitant, fosamprenavir) or a P-gp Inhibitor (eg cyclosporine, ranolazine), will be excluded