Heat a large soup pot over medium-high heat.
Add the sausage, onions and garlic to the pot and sauté until the onions are soft and translucent, about 5 minutes.
Add the chicken stock, crushed tomatoes and tomato paste. Whisk until tomato paste is fully incorporated.
Bring to a boil, season with salt, then simmer for 15 minutes. Add the kale, tortellini and heavy cream.
Simmer for 3-5 minutes until the kale is wilted, and the pasta is tender. Serve with parmesan cheese and red pepper flakes if desired.
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