I took a quick look in the profiler while running through the startup sequence yesterday and none of it looked like IO stuff directly:
1) Was mostly PSO compiles (as expected the first time)
2) Next most common was graphics driver stalls while creating resources/adjusting pool sizes. That sort of thing is a common target for IHVs to tweak buffer sizes, defrag timing, etc. for shipped games so sort of to be expected with a non-tuned workload as well. I imagine it will get better over time in drivers as well, especially now that we've forced people onto DX12 (thank god).
3) Remainder of the stalls I saw were things like spawning/deleting a ton of actors in a frame or something, which are demo issues in things like the crowd/traffic system that can also be improved over time (these systems are not core UE per se). These were the minority though.
Nothing looked categorically scary. The PSO situation sucks in general on PC, but there are some ways to mitigate that with PSO caches for a shipping game. A bunch of these stalls are because drivers are still doing rather conservative things (i.e. recompiling every hit shader in the scene) when it comes to RT PSO linking and that will likely improve further now that we've forced the issue as well.
Admittedly UE is a giant thing at this point, and certainly there's aspects on the CPU that are non-ideal. That said, I didn't see anything fundamentally unsolvable or needing esoteric tech here. The GPU side is already running quite smoothly and will only improve further.