INTEL

Enable virtualization in bios settings (VT-x)

For users who have Intel 8th gen and below processors; it is needed to disable the OS Meltdown mitigations to be able to load the hypervisor.
Some new generations may also have this enabled, it can be checked via the included InSpectre tool in the Hypervisor folder.
If the "Disable Meltdown Protection" button is grayed out, it is patched on hardware level for your CPU and no action is needed, proceed with the next steps.

Kernel anticheats will be problematic, make sure they are off before performing the rest of the steps.

Enable test signing mode via bcdedit (bcdedit /set testsigning on)
For users with Hyper-V windows feature enabled, it's required to keep its hypervisor off with the following command:
bcdedit /set hypervisorlaunchtype off

Keep Secure Boot disabled
Keep Windows Defender memory integrity and credential guard off (VBS and HVCI)

Usage:

In a cmd or powershell with admin rights, after meeting the requirements:

sc create denuvo type=kernel start=demand binPath=C:\Drivers\Hypervisor\hyperkd.sys (your full path for hyperkd.sys)
sc start denuvo

After you close the game, you can stop the hypervisor service with

sc stop denuvo

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Installation steps:

1 - Load the hyperkd.sys file in the "Hypervisor" folder. The .dll files must remain next to it.
2 - Copy and paste everything else apart from the hypervisor folders to the main game directory
3 - Launch MafiaTheOldCountry.exe

Disclaimer: Kernel drivers are able to cause blue screens when there are mistakes in the code, this has not yet been tested for long term stability.