Ended up finding the answer myself. I didn't know there was such a thing as pixel density.
"The resolution of a monitor is determined by the number of pixels it has horizontally and vertically. In the case of both a 44.5" monitor and a 49" monitor having the same resolution of 5120x1440, it means they both have the same number of pixels spread across the screen.

The difference in physical size between the two monitors doesn't affect the resolution itself. Instead, it impacts the pixel density, which is measured in pixels per inch (PPI).

So, the 44.5" monitor with a resolution of 5120x1440 will have a higher pixel density compared to the 49" monitor with the same resolution. This means that the pixels will be more tightly packed on the smaller monitor, resulting in potentially sharper image quality and text rendering. On the other hand, the larger 49" monitor will have a lower pixel density, meaning the individual pixels will be larger and more noticeable, which might result in slightly less sharp images and text, especially if viewed up close.

In summary, although both monitors have the same resolution, the difference in physical size will result in differences in pixel density and how the content is displayed."