Prior to VoH, I ran my game (PC) on a mix of Medium and High settings, with no restriction on FPS and Ray tracing turned off. The biggest issue I had was teleporting into busy areas would DC me, so I disabled Cross Connect until I needed people. 
This was my configuration the day before release and it was working great. A bit of lag while on a horse, but nothing unmanageable.
Post upgrade, once we were able to play on the 7th/8th, I’ve been plagued with lag and disconnects. The game forced me to upgrade my video card driver before I could play to a version released a week prior. I can’t play without the updated driver. I’ll come back to this.
To attempt to fix the performance issues, I changed my D4 graphics settings to Low with a max FPS of 60, and that seemed to help a bit. Unfortunately, it continued getting progressively worse. I tried 48 FPS last night, but even that changed nothing. I also make sure OneDrive is paused when I play and verify that my virus scan still has its exceptions in place. Nothing else is actively running on my PC. At this point, I can no longer play the game.
To make matters worse, I’ve also had multiple random Nvidia-related blue screens since the upgrade, even outside the game. All I can do is laugh. Laugh and laugh and laugh and laugh. If you made it all the way through, I’m sorry. I assume you’re having the same issues. Maybe someone will have an idea we haven’t already tried?
Edit: I was very tired when I finally submitted this. That last paragraph was fully of typos. lol Fixed.