In a large pot or Dutch oven, heat olive oil over medium-high heat. Add in the sausage and break up the meat with a spatula. Sauté stirring often for about 3-5 minutes, or until the sausage is cooked through. Carefully spoon out excess fat, if necessary. Remove from the pot and set aside on a plate.
To the pot, add the chopped onion, carrots, and garlic and sauté, for about 2-3 minutes or until the carrots have softened and the onions and garlic are fragrant.
Stir in the Italian seasoning.
Add in the flour and cook until lightly browned, about 1 minute.
Gradually stir in chicken stock and crushed tomatoes. Add in the salt and pepper.
Bring to a boil then reduce the heat and simmer, stirring often, until reduced and slightly thickened, about 10 minutes.
Add the tortellini pasta and cook according to package instructions, about 3 - 5 minutes, until just tender.
Stir in the parmesan cheese and spinach. Continue cooking until wilted.
Reduce heat to low and slowly stir in the heavy cream. Season to taste with salt and pepper as needed.
Serve garnished with fresh grated parmesan cheese, chopped basil and parsley (optional). Enjoy!