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No need to repair items, but important to swap out for upgrades as often as you can throughout the story as the armour/evasion ratings on the gear do make a difference.I did jump on for an hour and I'm undecided on what I think.
trying to get used to the controls coming from D4.
Do you need to repair your items? I seemed to have gone from doing ok to taking a lot of damage.
You should try to prioritize some resistances as soon as possible too via gear/crafting or the passive trees, they make a big difference even early on.
Pretty sure there is a ring base type that's available quite early on the gives an implicit roll of increased elemental resistances.