This may not work for everyone, but it seemd to work for me.
So i was leveling my alt in starving demons way and pilgrim lilya was missing. I went here to see if there was any announcements and the latest one says:
“Please note that, depending on your region, even after the patch your client could take some time to sync with the server. We suggest you try checking the integrity of your game files on Steam if you are experiencing problems after this maintenance.”
So i tried this. I deleted all my addons and checked integrity. 30 files missing. Reoped tos, launcher updated, reran it and it crashed. reran it the third time and it worked. Logged in and the npc was there.
Either it was lag before and thats why the npc was gone or this actually fixed it. not sure.
TL;DR: Try uninstalling addons and checking file integrity.