Wash and cut the peppers into bit sized pieces. Dice the onion. In a large skilled, sauté the onions and peppers until they begin to soften. Remove the sausage from its case and add to the vegetables, breaking the sausage apart with a fork. When the sausage is cooked through, and the onions are golden, add the tomato puree, and salt and pepper to taste. Cook over low heat for about 30 minutes until reduced, and then add the cream. Cook for an additional 10-15 minutes until further reduced.
Meanwhile, bring a pot of salted water to a boil, and cook the pasta until just shy of al dente. Drain the pasta and add it to the tomato mixture. Stir together over low heat for about a minute. Serve immediately with a sprinkle of Pecorino cheese.