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Lisa Taruffi,1,* Lorenzo Muccioli,1,* Micaela Mitolo,2,3 Lorenzo Ferri,1 Carlo Descovich,4 Stefania Mazzoni,2 Roberto Michelucci,2 Raffaele Lodi,1,2 Rocco Liguori,1,2 Pietro Cortelli,1,2 Caterina Tonon,1,2 Francesca Bisulli1,2 1Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; 2IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; 3Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; 4Clinical Governance, Research, Education and Quality Improvement Unit, AUSL Bologna, Bologna, Italy*These authors contributed equally to this workCorrespondence: Francesca Bisulli, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy, Tel +39 0514966937, Fax +39 05149669993, Email francesca.bisulli@unibo.itPurpose: We report our single-center experience on the neurological manifestations of long COVID.Patients and Methods: This is a retrospective observational study. All consecutive patients referred to the neurological long COVID outpatient clinic of our institute from January 21 2021 to December 9 2021 underwent a general neurological objective examination. Treatments and investigations (brain MRI, neuropsychological evaluation, or others) were prescribed on an individual basis as per standard clinical practice. A follow-up visit was performed when appropriate. Descriptive statistics were presented as absolute and relative frequencies for categorical variables and as means, median, and ranges for continuous variables.Results: One hundred and three patients were visited (mean age 50.5 ± 36 years, 62 females). The average time from acute COVID-19 infection to the first visit to our outpatient clinic was 243 days. Most patients presented with a mild form of acute COVID-19, with only 24 cases requiring hospitalization. The neurological symptoms mostly (n=70/103, 68%) started during the acute phase (before a negative swab for SARS-CoV-2). The most frequent acute manifestations reported, which lately became persistent, were fatigue (n=58/103, 56%), olfactory/taste dysfunction (n=58/103, 56%), headache (n=47/103, 46%), cognitive disorders (n=46/103, 45%), sleep disorders (n=30/103, 29%), sensitivity alterations (n=29/103, 28%), and dizziness (n=7/103, 7%). Tremor was also reported (n=8/103, 7%). Neuropsychological evaluation was performed in 30 patients and revealed alterations in executive functions (n=6/30, 20%), memory (n=11/30, 37%), with pathological depressive (n=9/30, 30%) and anxiety (n=8/30, 27%) scores. Brain MRIs have been performed in 41 cases, revealing nonspecific abnormal findings only in 4 cases. Thirty-six patients underwent a follow-up, where a general improvement was observed but rarely (n=2/36) a complete recovery.Conclusion: The majority of patients presenting persistent neurological symptoms (most frequently fatigue, cognitive disorders, and olfactory dysfunctions) developed a previous mild form of COVID-19. Further studies are required to develop therapeutic strategies.Keywords: COVID 19, neuroCOVID, follow-up, cognitive disorders, neuropsychology, hypo/anosmia