If you're talking about keeping your Neovim config: yes, due to the Neovim extension using the actual Neovim program (this was one of the new Neovim features: it includes a vim server that processes keystrokes and sends updates for use in a different UI). So it has no problem reading your vim config at startup.
Those relatively minor annoyances aside, vscode-neovim is perfectly workable for daily use.
You don't get the "absolute fullest" (neo)vim experience because you don't get the buffers/panes like you do in nvim though.
ctrl-w s : will split horizontally ctrl-w v : will split vertically
Commands work, and I just tested buffers specifically. I can type :buffers and I see a list. I was able to get vscode to switch tabs with :b 209 (I don't normally inspect buffers this way, but it's integrated and it works).