I am getting the exact same issue as both above posters! I have submitted an official bug report.
I am getting a significant delay to actions, once I hit the Lower City. Was not present in any other region before this.
Steam version, up to date drivers, tried every fix possible.
My hardware:
RTX 3070
Ryzen 7 5800X
I have to imagine not a massive amount of people have made it to the Lower City yet (it took me almost 100 hours, I took it very slow), so perhaps this issue is not as well known. Or it is affecting a specific hardware (maybe Nvidia 30-series cards??)
Hopefully it is patched or addressed, or someone finds a temporary fix in the interim. I am going to mess around more with Nvidia/game settings.