Have you been encountering stuttering when looking around with TrackIR, as if the action of looking around isn't nearly as smooth as it should be - despite having your framerate capped at 60 or 120?
Or have you been encountering low GPU usage and terrible performance in-game, but when you bring up the menu by pressing ESC, GPU usage and framerate returns to normal?
Well, I've found a potential fix. The same thing solved both these issues for me, on two separate occasions and with two separate graphics cards (2070 and 4070 SUPER).
In Nvidia Control Panel, press Adjust desktop size and position, then under the Perform scaling on: dropdown menu, select GPU. Do this for all connected monitors and click Apply. That's it.
I hope this helps. I've been pulling out hair trying to fix these issues, and in both cases the culprit turned out to be the same (it had apparently reset the setting to Display scaling when I got a new graphics card, which for some reason caused low GPU usage and terrible performance when not in the in-game menu).
If you have a different solution to either of these problems that worked for you, feel free to post it here. Cheers.