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SELECT 
  1 
FROM 
  cscart_ec_print_temp_designs 
WHERE 
  session_id = '1ZK4-3H1N-UU9Z-OQ46-IVA4-B8L1-WCUA-4XWL' 
  AND product_id = 154 
  AND expires_at > 1770196217 
  AND confirmed = 'Y' 
LIMIT 
  1

Query time 0.00022

JSON explain

{
  "query_block": {
    "select_id": 1,
    "message": "no matching row in const table"
  }
}