If you're struggling on PC, this is how I went from <20fps to solid 60FPS at 4K ultrawide (3840x1620) with DLSS amd RT enabled on a RTX 3070.

There's one specific setting that absolutely tanks performance for me, namely Cascaded Shadows Resolution. Changing this from high to medium more than doubled my FPS instantly. Not only that, but character dialogue went from single digit FPS to actually watchable.

Changing from low to high on most other settings did not yield much difference, we're talking single digits. I think this is why running everything at high is making the game run like dogpoo. Set everything else as high as you'd like, but always keep this setting at medium, max.