In a large skillet, sauté the onion and garlic in butter, over medium heat, until soft, not brown. Whisk in the pumpkin, broth, broth creams and seasonings to taste. Simmer 10 minutes, stirring occasionally, until slightly thickened.
Meanwhile, boil the pasta in salted water until al dente.
Drain the pasta and stir it into the pumpkin sauce, simmering 2 to 3 minutes more until thick.
Stir in parsley and garnish with Romano cheese. Stir in sausage, if using. Garnish with more parsley and cheese, if desired.