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SELECT 
  1 
FROM 
  cscart_ec_print_temp_designs 
WHERE 
  session_id = 'NCCS-3DSZ-DQQU-JOPM-XXN4-W2HX-NRB7-CJOJ' 
  AND product_id = 208 
  AND expires_at > 1770974278 
  AND confirmed = 'Y' 
LIMIT 
  1

Query time 0.00056

JSON explain

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