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The victory helped Tsitsipas join Rafael Nadal as the only active player to win consecutive titles at Monte Carlo, with the likes of Juan Carlos Ferrero, Thomas Muster, Bjorn Borg and Ilie Nastase also achieving the feat during their playing days.
Atalanta goalkeeper Juan Musso saved a penalty and a follow-up attempt but he couldn't keep out an own-goal by Davide Zappacosta from the resulting corner as Leipzig salvaged a 1-1 draw.
The United States, who missed out on the 2018 tournament, lost 2-0 to Costa Rica but still progressed along with the Mexicans, who beat El Salvador 2-0.
The former world No. 1 will be out of action for three weeks.
Former top 10 player H S Prannoy also struggled past Finland's Kalle Kolionen 19-21, 21-13, 21-9 to find a place in the quarters as did former Commonwealth Games gold medallist Parupalli Kashyap.
Miss India Manasa Varanasi stood 11th at the international beauty pageant.
Hyderabad had won the first leg 3-1 through goals from Bartholomew Ogbeche, Yasir Mohammad and Javier Siverio.
United are left to focus on a Premier League campaign where they face a real battle to make the top four and earn a place in next year's Champions League.
The result means both sides have four points from their first two matches this season.