Cook pasta according to package directions. Meanwhile, in a large skillet, cook sausage over medium heat until no longer pink, breaking into crumbles. Remove with a slotted spoon; drain on paper towels. Discard all but 1 tsp drippings. Cook and stir onion and garlic in oil and reserved drippings over medium-high heat until tender. Add wine and bay leaf. Bring to a boil; cook until liquid is reduced by half.
Stir in the broth, pumpkin, 1 1/2 tsp sage and remaining seasonings; cook 1 minute longer. Add the cream and sausage; heat through. Remove bay leaf.
Drain pasta; transfer to a large bowl. Add sausage mixture; toss to coat. Sprinkle with cheese and remaining sage.