I had the same thing happen. Game performing like absolute garbage and no setting change, no amount of closing stuff, no amount of updating or rolling back drivers helped. Even tried a backup clean install of win 10 I keep on a second SSD - same thing. To be clear when I say "no setting change" helped - I mean it was still running terribly lowering it to 720p low preset. In fact, performance seemed almost quality-setting-agnostic as cranking everything up didn't hurt it either.
Modest setup with an i7 10700k, 64 GB ram(yes, xmp enabled), 3070 and an nvme ssd (yes it's not more than half full, and yes I've trimmed it)... would start at reasonable fps and rapidly drop towards 15 fps in some of the worst offending areas (crowded locations and locations with lots of dynamic sounds/conversations - goblin camp, druid grove, and the beach for some reason). Elsewhere it was closer to 25 fps ~ 30 fps. Had been running at ~119 (I capped it) but after the last hotfix it was just running awful. If I loaded the game in an uncrowded interior, sometimes I'd have playable framerates and responsiveness for up to 30 minutes, then it would tank as soon as I went outside or got near any npcs.
Used resource monitor and task manager to check for useage and maybe bottlenecking behavior. Other than bizarrely low useage of both CPU (~33-40% peak) and GPU (both utilization % and memory useage were consistently under half) - nothing appeared to be causing the slow down. The weirdly low utilization made it seem like windows 10 decided to treat the game like a background process instead of an application/game though.
Trying things like windows game mode did nothing, but manually setting the priority of the process to "high" and core affinity to exclude cores 1,3,5, and 7 returned performance to what I expected. Priority helped a little bit and I can understand that on some level kind of, but I'm really not sure why core affinity helped (it was responsible for about half my return to expected performance.) I vaguely understand that what I did by setting the affinity like that was prevent the game from running it's threads on both logical cores that make up single physical cores, but not why that helped.
Based on resource utilization and performance - and the fact that changing priority/affinity had such a big effect for me (it almost always seems trivial at best in most games) it really does seem like windows 10 scheduler decided all of the sudden that BG3.exe and BG3_dx11.exe were a background process...