we downgraded to Windows Server 2012 R2 and now it seems like the issues are gone (we run Azure and AWS instances). Azure SQL seem to be closest related to sql server 2014.
For the Windows 2012 servers I did install the PHP 7.3.7 package that came with "web platform installer" and also the SQl Server driver 5.6 for that PHP version.
Don't think it is neccessary or needed for the SQL connections but have added curl and ssl cacert path in php.ini (it is needed for pushing data to AWS S3 though).
I also tested IIScrypto to adjust registry settings to use either TLS 1.2, all TLS, different cyphers, the solutions in the above links but no success.
The problems started with windows update or possibly a sql server update and it is intermittent making it hard to find out. Clearly related to communication but not reproducable "on demand".
We are moving the solution to a Linux platform as soon as the rest of the legacy (.asp/.aspx) scripts are converted to php.
My best bet is to use the latest php and latest sql driver from "web platform installer", also update to latest ODBC driver if you need but we are running now with the version 17 (2017.173.01.01) 2/14/2019 that came with the Windows server 2012R2 image.