I finally was able to get around to playing this on the weekend. It was a blast. I played it a bit on all three rigs. Totally loving it but I have one complaint. The HDR toggle seems backward. I often have MSI AB running to keep an eye on things and it changes colors when HDR is enabled. The in-game toggle is either off/auto (presumably switching on if it detects that everything is in place). With this game, auto shows as off and when I toggled it to off AB showed as on. I also noticed how the visuals became more vibrant, just as they should. I saw something like this once years ago with RE 7 Biohazard as well.
As nearly every game I've played in the last 3-4 years has HDR, and has worked flawlessly, and I've got extensive experience in checking that everything from hardware to OS is switched on, I definitely know this is an issue with the game. I also saw this consistently with all three rigs (2 with newest NV drivers and I think one of them is running a driver from around a month ago).
Other than that the only thing I noticed is that even at 4K the game can be rather CPU intensive if playing at above 60 FPS. I noticed the AIO fans cranking up for 5800X3D when playing with the C2 (4K/120 Hz). It was able to push 90-117 (frame cap for G-Sync) with everything maxed and DLSS quality. CPU usage was around 50-60%, 100% during shader caching. Since this rig also has a 4090 I was able to turn off DLSS and use TAA at max and then frames dropped to around 60-80 FPS. CPU dropped as well but not by much. The rig in the cave with the Z9D (4K/ 60Hz) was V-Sync capped at 60 fps and so that processor (same CPU with the same AIO) ran a bit cooler since usage was a bit lower. That is also in the biggest case which also has more intake fans.
The 3700X rig behaved similarly at 5120x1440 100Hz. Using DLSS quality it was able to average 70-90 FPS, CPU usage was 50-60% as well with that AIO keeping it around 60-66c. Since this is also my smallest case it is expected to work a little harder. Although this 3090 Ti was easilly doing 2145 MHz, occasionally 2160 MHz, turning off DLSS still dropped FPS to around 40-60 and this is not the kind of game you want lower frames. I will say though, DLSS is pretty good but when doing camera pivots there are very noticeable trails around Isaac. I noticed when turning DLSS off that there's perceivable transparencies around him so I think those are what's causing the trails with DLSS. I ended up locking frames at 60 FPS and the CPU/GPU were both a bit happier. That power-hungry 3090 Ti even dropped to around 230 Watts of consumption and the boost clock occasionally seemed to disengage.
Overall, though, I had a blast and can't emphasize enough how great the game looks in 32:9. It looked good on all three displays but the CRG9 handled it well and it was nice to position Isaac so as to be able to see the monsters as they attempted to sneak up. It scaled perfectly with no distortions/stretching at the sides which is something that's still common to a lot of games said to support 32:9. I'm not quite done, on chapter 5 or 6 (I forget which), but really looking forward to finishing it. As other reviews have mentioned, the game still has some stutters but I didn't find it too bad and for the most part, things were pretty smooth.