In a large pot, cook the spicy Italian sausage over medium heat until browned. Break it into bite-sized pieces as it cooks.
Add diced onions and minced garlic to the pot. Sauté until the onions are translucent and the garlic is fragrant.
Pour in the chicken stock and water. Add diced tomatoes, Italian seasoning, oregano, salt, and pepper. Bring the mixture to a gentle boil.
Drop in the tortellini and let it cook according to the package instructions. It usually takes around 7-10 minutes.
Once the tortellini is cooked, stir in the fresh spinach. Let it wilt in the hot soup for a couple of minutes.
Lastly, add the heavy cream, and stir it in. Continue cooking for an additional minute.
Ladle the soup into bowls and serve it hot. Grate some Parmesan cheese on top for an extra flavor boost.
