Crashing here as well, game is completely unmodded, freshly installed and playing on a fresh save. For me the trigger for the crashes seem to be talking with Astarion.
EDIT: I fixed the issue from my end by clearing shader cache and ckearing AppData. Once I did those, the launcher recognized an error within the files, and pointed to a Patch 4 Hotfix pak file that was still laying around in Data folder of the game, I deleted the pak file and now I can talk to Astarion once again without crashing! Here's the instructions I followed:
https://steamcommunity.com/sharedfiles/filedetails/?id=3018203217
