Heat a Dutch oven or heavy-bottomed pot over medium-high heat. Add the sausage, breaking into small pieces. When the sausage is mostly cooked, add the onion, carrot, and celery. Season with salt and pepper. Cook for 5 minutes, occasionally stirring.
Add the garlic, spices, and tomato paste. Cook for a few more minutes or until fragrant. Stir to prevent the paste from burning.
Add the chicken broth, scraping the bottom. Bring to a boil, reduce heat, and simmer for 15 minutes.
Add in the heavy cream, tortellini, and spinach at a low simmer. Mix to combine. Simmer until the tortellini are al dente. Serve and top with Parmesan cheese.