Abstract RationaleSymptoms following acute COVID-19 infection are common, but their relationship to initial COVID-19 severity is unclear. We hypothesize that residual symptoms are related to disease severity, and severe acute COVID-19 infection is more likely to cause residual pulmonary damage. This study aims to evaluate symptoms, lung function and abnormal imaging within 3 months following COVID-19 infection, and whether they are related to initial disease severity.Methods A cross-sectional study was carried out at a designated post-COVID clinic in Hadassah Medical Center, Jerusalem, Israel. Patients with PCR-confirmed SARS-CoV-2 infection were evaluated within 12 weeks following infection and included both admitted and non-admitted subjects. All participants underwent assessment of symptoms, quality of life (SGRQ), pulmonary function tests, and imaging. Results A total of 208 patients (age 49.3±16 years) were included in the study. Initial disease severity was mild in 86, moderate in 49 and severe in 73 patients. At the time of follow up, there were no differences in frequency of residual symptoms or in SGRQ score between groups. Patients with severe COVID-19 were more likely to have residual dyspnea (p=0.04), lower oxygen saturation (p<0.01), lower FVC and TLC (p<0.001, p=0.03 respectively), abnormal CXR (p<0.01) and abnormal CT scan (p<0.01) compared to other groups. Conclusion Frequency of symptoms and impairment of quality of life at 12 weeks follow up are common and are not related to severity of initial COVID-19 disease. In contrast, reduced lung function and abnormal pulmonary imaging are more common in patients with more severe acute COVID-19 infection.