Post 3.21.2 extreme lag spikes and stuttering

Hey

Before patch 3.21.2 I played the game for years on high graphics with good performance. After the patch I've been getting noticeably longer loading screens and lag spikes during combat that can and have result in character death.

Heavy partial effects exacerbate this problem. Harbingers spawning new adds, delirium fog even releasing essences cause this. MTX transmog, pets and auras also seems to make this worse.

For accouple days I Have tried every combination of graphic settings with only limited results.

PC specs
Nvidia Rtx 2070 8gb
i7-9700k @ 3.60ghz
16gb ddr4
1920x1080 144hz