In a large pot, heat a drizzle of olive oil over medium heat. Add the Italian sausage, breaking it apart as it cooks. Sauté for 5–7 minutes until browned.

Add chopped onions and sauté for 3–4 minutes until translucent. Stir in minced garlic and cook for an additional minute.

Pour in the canned diced tomatoes with juices and chicken broth, stirring to combine. Bring to a gentle simmer for about 5 minutes.

Introduce the cheese tortellini and cook according to package instructions, typically about 5 minutes until tender.

Stir in spinach and let wilt for 1–2 minutes. Reduce heat to low, mix in heavy cream and Parmesan, heating for 2-3 minutes.

Season with salt, black pepper, and red pepper flakes to taste. Ladle into bowls and serve with crusty bread.