This study explores the long-term neurological impacts of COVID-19, focusing on cognitive impairments associated with glial cell alterations, gender-specific manifestations, and their interrelation with new-onset diabetes. Advanced neuropsychological assessments were used to evaluate cognitive deficits in post-COVID patients, highlighting the roles of glial dysfunction and metabolic health. Since the pandemic's onset, COVID-19 has challenged healthcare paradigms, revealing diverse psychophysical sequelae, including significant cognitive impairments such as memory deficits, attention disorders, and executive dysfunctions. Recent studies (Pubmed 2022-2023) underscore the importance of integrating metabolic health management into post-COVID care due to a bidirectional relationship between diabetes and cognitive decline. The study aims to detect encephalic alterations through neuroimaging, correlate these with cognitive deficits, and investigate the hypothesis that COVID-19-induced neuroinflammation leads to executive dysfunctions. The findings aim to enhance global understanding of COVID-19’s neurological effects and inform targeted therapeutic approaches. [1,2,3]. Results A total of 245 individuals (average age 56,8 ± 12 years, 39,60% female, 60,40 male) were assessed on average at 150 ± 47.0 days since symptom onset. Persistent self-reported neurological symptoms were found in the areas of sleep (35%), attention (57%), and memory (74%). The MMSE mean score was 24,8. In total, 87 subjects (20.7%) achieved pathologic neuropsychological test results. A high prevalence of failed tests was found in digit span backward (28.7%), trail making (27.4%), and FAB (38.9%). Cognitive status was associated with a number of factors including cardiovascular disease history, persistent fatigue, age, anxiety, and mental health stress. Numerous frontal prefrontal, temporal and limbic gliotic areas were found in NMR. The study underscores the extensive cognitive impairments in post and long COVID patients, highlighting the critical role of glial cell dysfunction. Notably, the research revealed significant gender differences in cognitive outcomes and established a link between new-onset diabetes and exacerbated cognitive deficits. These findings advocate for targeted interventions to address the neurological sequelae of COVID-19, emphasizing the need for ongoing research into the mechanisms underlying these persistent cognitive impairments.

Concetta Mezzatesta is a Psychologist, Psychotherapist, Traumatic Disaster Manager and Coordinator of Psychologists of Covid Hospital of Partinico in Sicily Italy. She is working with Prof. Vincenzo Provenzano and his clinical team. For about two years she has followed covid patients during hospitalization (Head of the "End of Life" therapeutic project) and in the Long covid clinic dealing with psychotherapy to support psychic pathologies and neuropsychological evaluations and neuropsychological rehabilitation, a neuroscience sector that deals with the rehabilitation of people suffering from focal or diffuse brain diseases that determine the impairment of one or more cognitive and / or behavioral functions. She has dealt with the "end of life" of patients suffering from neurodegenerative diseases and family members. She carries out research on issues related to: psychiatric, neurodegenerative and Neuro long covid pathologies. She has held numerous positions as Professor and Adjunct Professor of Clinical Psychology, Psychopathology and Psychometrics at various public facilities: including the University of Palermo, Trapani and Messina and Scientific Clinical Institutes Clinical Work and Rehabilitation. Currently a Member of the Scientific Committee and the Board of Directors of the Italian Scientific Society for Metabolism, Diabetes, and Obesity SIMDO.